Why success must not result in a lessening of vigilance
What does Thailand's success in controlling leprosy have to teach other countries? A review of case detection trends between 1965 and 2005 published in the WHO's weekly epidemiological record contains some pointers
Thailand introduced a national leprosy control program in 1955, reducing prevalence of the disease from 50 per 10,000 population in 1953 to 12.42 in 1971. Based on this success, it decided in 1971 to integrate leprosy control activities into the general health care services.
From 1971 to 1975, approximately 1,100 to 1,800 new cases were detected annually (3.2 to 4.1 per 100,000 population). As the pace of activities picked up, the number of new cases detected annually increased, peaking at 4,463 in 1981 (9.5/100,000). Since then, the number has fallen to 638 cases in 2005 (1.03/100,000).
The review concludes that multiple factors have contributed toward this decline, including improved access to diagnosis and treatment and increased socioeconomic development leading to better living conditions. However, it also illustrates why continued vigilance is required.
While the absolute number of new cases presenting with grade 2 disabilities has declined, the proportion of new cases has fluctuated between 11% and 15%. This suggests that as leprosy becomes less prevalent, awareness among health staff and the general public will likely lessen, which could result in delays in self-reporting. Hence Thailand's success also underscores the importance of maintaining control activities.
'NOTHING FOR US WITHOUT US'
A Western Regional Empowerment Workshop was held in Mumbai, India, on November 23. Some 570 delegates, mostly from leprosy colonies in Rajasthan, Gujarat, Maharashtra and Chhattisgarh attended. Organized by the National Forum, the conference also saw the launch of MITRA ("friend"), a newsletter in Hindi and English to reflect the views of people affected by leprosy.
LEPROSY CONTROL IN POST-ELIMINATION ERA INDIA
A group of experts met on November 7 in Chennai to discuss methods for monitoring and evaluation of leprosy control in India in the post-elimination era. The meeting was organized by the Indian government, WHO and Indian Council of Medical Research. Its recommendations will be published shortly.
According to World Health Organization figures published in November, registered prevalence of leprosy by WHO region (excluding the European Region) at the beginning of 2007 stood at 231,361 cases. New cases detected during 2006 totaled 265,661.