Leprosy ratio high in western Maharashtra: Survey

“Over one third of the newly detected cases were children,” he said.

A house-to-house active survey for the enumeration of undetected leprosy cases was undertaken by Foundation in 2007 in defined rural and urban areas of Western Maharashtra where leprosy was claimed to be below elimination levels,Shetty ,the chief investigator of the study said.

The study had cases from the public and private health sector in this area,the director of the institute Dr Nerges Mistry said adding that details of the study ‘Burden of Leprosy—Recent Findings’ which has been recently published in a scientific journal,will be presented to media on Saturday.

A situational analysis in the same population highlighted lack of awareness,strong perception of stigma in patients,attrition of skills in workers of the public health system and implementation of policies that do not truly reflect the burden of disease.

Some of the implications of a high burden of undetected leprosy is that elimination may not be achieved uniformly throughout the country.

Burden of leprosy therefore is underestimated through the missing of its diagnosis. Transmission of disease will continue and may even expand in vulnerable populations,FMR director said.

Its complications of severe deformities,widespread nerve damage and the socio-economic repercussions of stigma will continue down the ages.

Therefore,the maintenance of essential skills for diagnosis,treatment and rehabilitation and the formulation of policy,based on sound evidence and the knowledge of emerging paradigms from medical research and technology must form the crucial arms for leprosy control,Mistry said.

Inclusion of the private sector for skill generation,treatment guidelines and surveillance efforts is also a necessity,she added.

Leprosy for centuries has been a major public health problem in India. Currently the national prevalence figures estimate 91,744 leprosy cases in India. In the year 2000 when elimination of leprosy as a public health problem was visualized,India was among 12 countries with a prevalence rate (PR) above elimination level accounting for approximately 64% of the global burden,Mistry said.

With massive inputs by the Government of India through the National Leprosy Elimination Programme (NLEP) between 2001-2005,the prevalence of leprosy was reported to reduce by 80 per cent.

Mistry said,in 2007,the Southeast Asia region,specially India,registered the highest number of new cases and a decline of only one per cent in the number of new cases between 2006 and 2007.

This is indication of a considerable slowing down of disease decline had warned the global community to take proactive steps in determining its causes,she said.

“One of the immediate steps identified in the collection of data in large countries is the focus on new-case-detection through either sentinel surveillance or sample surveys,” she said.

Validation of reported low endemicity or use of surrogate measures for analysing trends of new case detection has been recommended for use by national programmes,added Mistry.

“However the sharp decline in the prevalence of leprosy in India has coincided with the withdrawal of active case detection strategy by the public health system in 2001,” she added.

The implementation of these recommendations is further fraught with questions of whether leprosy can still be considered a priority or a relatively rare disease.

The political announcement of elimination has undermined the value of surveillance or sentinel surveys and the concept of transmission of disease is therefore bypassed to the extent that even in a programme like National Rural Health Mission (NRHM),training of community health workers for leprosy has been neglected,Shetty added.