India Isn't Leprosy Free Yet: Health Campaign Data Shows Rise In 'Hidden' New Cases Of The Disease
India is still not entirely free of leprosy.
A patient shows the effects of leprosy on his hands in a Leprosy Hospital. (Image: Reuters)
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Mumbai: Almost 15 years after India was declared a leprosy-free country, Leprosy Case Detection Campaign (LCDC), which was conducted in 2018, discovered several new cases of the disease across the country.
Maharashtra, which is the third highest state in terms of new leprosy cases detected also saw a rise in new case detections as compared to last year. "We organised a Leprosy Case Detection Campaign (LCDC) in which we registered more than 5,120 new cases. We did house visits with the help of ASHA volunteers and covered almost 100% of the rural population and about 30% of the urban population during this campaign," said Dr Padmaja Jogewar, Joint Director Leprosy and Tuberculosis, NLEP (National Leprosy Eradication Program).
"The percentage of new cases may be increasing, but MB (multibacillary) cases percentage as compared to last year is decreasing. It's good news to detect these cases. Our motto is to look for hidden cases because if a patient is detected in early stages than the chances of infection transmission is greatly reduced," she added.
WHO had set the goal of eradicating leprosy by 2020, and Jogewar says while that's a possible goal to reach, their focus now is to identify every hidden case of leprosy in the country so that they can be sure that they have gotten rid of the disease. Under LCDC, not just the leprosy patients, but the 20 people who come in contact with each of these patients are also given preventive treatment so that they do not get infected.
"During this eradication campaign conducted in 2018 many disability cases, and child cases also came to light." pointed out Ex Director of Health Services, Maharashtra Government, Dr Sanjeev Kamble.
"We have to do more search activity, evaluation, and screening in the village level. What is more important is to reach out to tribal pockets, BPL (below poverty line) segment and slums and spread awareness about leprosy," he added.
Kamble pointed out that after the prevalence rate of leprosy became less than one in every 10,000 people, the leprosy program was integrated into the general health program in 2005. Since then the focus on leprosy isn't as much as it was before, which is why the detection has been slower, but the new LCDC program is surely a step in the right direction.
In Mumbai alone, 36 new hidden cases of leprosy were identified last year (April-December 2018) as compared to the previous year (April-December 2017). The total number of hidden cases that was detected during the campaign is 362 in Mumbai in 2018.
Dr V.V Pai, the director of Bombay Leprosy Project (BLP) said that while leprosy is often misconstrued as contagious, that notion isn't entirely correct.
"Leprosy is not contagious but surely a mild infectious disease and most of the population is naturally immune to the disease. Only 2 to 5% of people develop leprosy and in that, 80% will develop a mild form of the disease and the rest 20% will be infectious cases," said Dr Pai.
While the LCDC program has done a commendable job of identifying hidden cases, Dr Pai suggests, "The campaign is based on screening of population by ASHA workers in rural areas and volunteers, CVs in urban areas. But what is needed is that the health workers undertaking the survey should be trained to suspect primarily early multibacillary cases with signs of shiny oily skin of the face, thickening, redness of the skin of face, ears so that the individuals with infectious type are confirmed early enough and put on multidrug therapy early to break the chain of transmission and prevent secondary cases in the community."
The Bombay Leprosy Project's approach has been to work directly with the community rather than hospital-based diagnosis and treatment of leprosy. The advantage of the community approach is that leprosy patients continue to live with their family members and do not feel isolated and ostracized by society."
Due to the successful treatment strategy comprising MDT (Multi Drop Treatment) implementation, several thousands of leprosy patients around the world have been declared cured and this positive message has resulted in the overall reduction in stigma. However, stigma still prevails in rural areas. "BLP has been practising since beginning the concept of Integrated Rehabilitation to integrate leprosy related disability and other general disability to eliminate the stigma. The current treatment is given on an outpatient basis and this helps the patients to continue the treatment and continue his job without getting displaced from the community and this too helps in eliminating the stigma," added Dr Pai.
Maharashtra, which is the third highest state in terms of new leprosy cases detected also saw a rise in new case detections as compared to last year. "We organised a Leprosy Case Detection Campaign (LCDC) in which we registered more than 5,120 new cases. We did house visits with the help of ASHA volunteers and covered almost 100% of the rural population and about 30% of the urban population during this campaign," said Dr Padmaja Jogewar, Joint Director Leprosy and Tuberculosis, NLEP (National Leprosy Eradication Program).
"The percentage of new cases may be increasing, but MB (multibacillary) cases percentage as compared to last year is decreasing. It's good news to detect these cases. Our motto is to look for hidden cases because if a patient is detected in early stages than the chances of infection transmission is greatly reduced," she added.
WHO had set the goal of eradicating leprosy by 2020, and Jogewar says while that's a possible goal to reach, their focus now is to identify every hidden case of leprosy in the country so that they can be sure that they have gotten rid of the disease. Under LCDC, not just the leprosy patients, but the 20 people who come in contact with each of these patients are also given preventive treatment so that they do not get infected.
"During this eradication campaign conducted in 2018 many disability cases, and child cases also came to light." pointed out Ex Director of Health Services, Maharashtra Government, Dr Sanjeev Kamble.
"We have to do more search activity, evaluation, and screening in the village level. What is more important is to reach out to tribal pockets, BPL (below poverty line) segment and slums and spread awareness about leprosy," he added.
Kamble pointed out that after the prevalence rate of leprosy became less than one in every 10,000 people, the leprosy program was integrated into the general health program in 2005. Since then the focus on leprosy isn't as much as it was before, which is why the detection has been slower, but the new LCDC program is surely a step in the right direction.
In Mumbai alone, 36 new hidden cases of leprosy were identified last year (April-December 2018) as compared to the previous year (April-December 2017). The total number of hidden cases that was detected during the campaign is 362 in Mumbai in 2018.
Dr V.V Pai, the director of Bombay Leprosy Project (BLP) said that while leprosy is often misconstrued as contagious, that notion isn't entirely correct.
"Leprosy is not contagious but surely a mild infectious disease and most of the population is naturally immune to the disease. Only 2 to 5% of people develop leprosy and in that, 80% will develop a mild form of the disease and the rest 20% will be infectious cases," said Dr Pai.
While the LCDC program has done a commendable job of identifying hidden cases, Dr Pai suggests, "The campaign is based on screening of population by ASHA workers in rural areas and volunteers, CVs in urban areas. But what is needed is that the health workers undertaking the survey should be trained to suspect primarily early multibacillary cases with signs of shiny oily skin of the face, thickening, redness of the skin of face, ears so that the individuals with infectious type are confirmed early enough and put on multidrug therapy early to break the chain of transmission and prevent secondary cases in the community."
The Bombay Leprosy Project's approach has been to work directly with the community rather than hospital-based diagnosis and treatment of leprosy. The advantage of the community approach is that leprosy patients continue to live with their family members and do not feel isolated and ostracized by society."
Due to the successful treatment strategy comprising MDT (Multi Drop Treatment) implementation, several thousands of leprosy patients around the world have been declared cured and this positive message has resulted in the overall reduction in stigma. However, stigma still prevails in rural areas. "BLP has been practising since beginning the concept of Integrated Rehabilitation to integrate leprosy related disability and other general disability to eliminate the stigma. The current treatment is given on an outpatient basis and this helps the patients to continue the treatment and continue his job without getting displaced from the community and this too helps in eliminating the stigma," added Dr Pai.