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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

AFRICA REPORT: DR Congo Makes Headway

Data shows country passed the elimination milestone at the end of 2007.

Since 2005, the DR Congo (DRC) has been classified as one of the countries yet to achieve the WHO-set target of eliminating leprosy as a public health problem, attained when the disease prevalence rate falls below 1 case per 10,000 population.

Following a visit by Goodwill Ambassador Yohei Sasakawa in 2005, the DRC undertook to reach the elimination goal by December 31, 2007. With the data now available to us, we can confirm that this goal was achieved at the end of last year. At time of writing, the prevalence rate of the disease at the national level stands at 0.97/10,000.

Children in Kivuvu, Bas-Congo Province

LONG ROAD AHEAD

But eliminating the disease as a public health problem does not mean an end to the fight against leprosy in the DRC. We still have a long road ahead of us. That is why, under the current WHO global strategy for 2006-2010, we are working to further reduce the leprosy burden in our country. This is also in accord with our health minister's vision to eliminate leprosy at the provincial level and to strengthen the quality of services for preventing leprosy-related disability and for rehabilitating those affected by the disease.

With a total of 8,820 new cases of leprosy reported in 2007, the DRC is one of the biggest sources of leprosy cases in Africa. The provinces that give the most cause for concern are: Katanga, Equateur, Orientale and Bandundu.

The rise in new cases reported in 2007 is due, among other things, to the increase in the geographic coverage of the national leprosy elimination program thanks to the return of peace and to the implementation of minielimination campaigns in the health zones of Moba (Katanga), Ango (Orientale) and Kiri (Bandundu).

The small proportion of new cases with Grade II disability (8.42%) is testament to early detection of patients, as a result of improved case detection, due to greater community awareness and participation in leprosy control activities.

Map of the DR Congo showing high-endemic provinces

LEPROSY HOTSPOT

Tanganika, in Katanga Province, remains one of the most leprosy-endemic districts in the entire country, with the problem centered on the health zones of Moba, Nyunzu, Kalemie and Kansimba.

In Orientale, the problems are in the health zones of Ango, Ubundu, Doruma, Wamba, Bafwabaka, Bafwasende and Banalia. In Equateur, the focus is Tshuapa district, with the health zones of Bokungu, Mondombe, Wema, Yalifafu and Ikela. And in Bandundu, the problem is concentrated in the district of Maindombe, with the health zones of Kiri, Pendjwa, Inongo and Banzow.

We recognize that the leprosy elimination program has made great efforts in the detection of cases, and especially in taking responsibility for patients. This translates into a prevalence/detection ratio of 0.74, due mainly to the improvement in cure rates in almost all provinces.

We are now focusing mainly on reducing the leprosy caseload in the DRC, and at the same time on strengthening the strategy for preventing disability and rehabilitating people affected by the disease.

Decline in Leprosy in the DRC (1987-2007)


AUTHOR:Dr. J.N. Mputuluengu . B

Dr. Mputuluengu . B is director of the Democratic Republic of Congo's national leprosy elimination program.