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 a contagious disease that affects the skin, mucous
membranes, and nerves, causing discoloration and lumps
on the skin and, in severe cases, disfigurement and
deformities.
 Leprosy is now mainly confined to tropical Africa and Asia.
causes:
Leprosy is caused by a slow-growing type of bacteria
called Mycobacterium leprae
Tuberculoid leprosy
Borderline tuberculoid leprosy
Borderline borderline leprosy
Borderline lepromatous leprosy
Lepromatous leprosy
 Paucibacillary Leprosy (PB) :
skin lesions with no bacilli seen in the skin smear
 Multibacillary Leprosy (MB):
skin lesions with bacilli seen in the skin smear
 Discolored patches of skin, usually flat, that may be numb and look faded
(lighter than the skin around)
 Growths (nodules) on the skin.
 Thick, stiff or dry skin.
 Painless ulcers on the soles of feet.
 Painless swelling or lumps on the face or earlobes.
 Loss of eyebrows or eyelashes.
 Examine skin
 Check for patches
 Test for sensation
 Count the number of patches
 Look for damage to nerve
 In 1941, promin introduced,but painful injections.
 In 1950s, Dapsone pills, but resistance developed.
 In 1981, WHO recommends multi drug treatment (MDT): Dapsone,
Rifampicine, Clofazimine
 Patients under treatment should be monitored for drug side-effects,
leprosy reactions and for development of trophic ulcers
Steps to start MDT
 Classify as PB or MB leprosy
 Inform patient about the disease.
 Explain the MDT blister pack - show drugs to be taken once a month and
every day
 Explain possible side effects (e.g. darkening of skin) and possible
complications and when they must return to the health centre
 Give enough MDT blister packs to last until the next visit.
 Fill out the patient treatment card
 The National Leprosy Control Programme (NLCP) an been started since
1955 In 1983 Government of India redesignated into Leprosy Eradication
Programme and introduced multidrug theraphy (MUT).
 The World Health Assembly in May 1991 adopted a resolution for global
leprosy elimination as public health problem by the year 2000 After the
declaration of the global target was reset for the remaining 15 countries
to achieve elimination at the national level creating by the end of
December, 2015.
 India was one of these level for countries. The National Health Policy of
India 2002 also through set the goal of leprosy elimination in India by the
end of -Samooh, year 2005.
• enumerates the strategies of NLEP
• discuss MDT explains the strategies for NLEP
• states the organization of NLEP
• describe the roles of key persons
• enumerate the infrastructure
 list the institute involved in anti-leprosy activities
 discuss Modified leprosy elimination campaign
 explains NLEP action plan, strategies and indicators
 describes the DPMR
 list nurses responsibility
 1948-hind kusht nivaran sangh
 1955- govt. of India launched NLCP
 1983- launched NLEP and introduced MDT for treatment
 1991- WHO declaration to eliminate leprosy at global level by 2000
 1993-2000 World bank supported NLEP 1st
 2001-2004 World bank supported NLEP 2nd
 2005 national program continues with GOI funds
 2005 - India achieved elimination of leprosy at national level December 05
 Sponsored by central government
 Funding pattern central government
 Ministry / department - DGHS✓Beneficiaries-individual and community
 Eligibility criteria anyone
 Early case detection
 Short term multi drug therapy
 Health education
 Rehabilitation services
 Identifying case detection and MDT coverage in high prevalence states
and areas difficult to access
 Strengthening laboratory services PHC/CHC, establishing surveillance
 Preparing for and initiating horizontal integration of leprosy program in
to primary health care system
• Providing greater emphasizes on disability prevention and treatment
•Implementation of modified leprosy elimination campaign
• Ensuring rehabilitation of cured patients
■ Early detection of leprosy cases
■ Intensified health education and public awareness campaigns
■ Regular treatment of leprosy cases providing multi- drug therapy( MDT)
at fixed centers near the patient
■ Disability prevention and medical rehabilitation
 Center level: DGHS and NLEP officer [NLEP commissioner for planning
and policy ]
 State level : director of health and services and state NLEP officer
 Regional level: Regional NLEP officer [Leprosy control unit, Survey
education and treatment, and Urban leprosy unit ]
1. The leprosy control units
2. Survey education and treatment centers
3. Urban leprosy centers
 These are established in endemic areas with one medical officer 2 non-
medical supervisor and 20 para medical worker .Each unit covering a
population of 4.5 lakhs, each paramedical workers covers a population of
15 to 20000 and is expected to examine at least 8000 persons per year
the team consists of one paramedical workers for 20 25000 population. One
medical supervisor for every 5 paramedical workers. these centers
attached to PHCS
One established for every 30-40 thousand population. At central level, the
leprosy division of the directorate general of health services, New Delhi is
responsible for planning, supervision and monitoring of program
■ Late detection of patients, many with visible deformities
■ Poor treatment completion and cure
■ Fear, prejudice and stigma surrounding leprosy
■ Limited community awareness and involvement
Find the source of infection
 Assist in the examination of household contacts especially children
 Education on the early sign and symptoms of leprosy
 Help the patients and family to understand the nature of disease
 Observe all patients in clinic
Educate patients on care of feet, skin, eyes et
Educate members of family and community by imparting correct
knowledge.
 Dispel misconception, misbeliefs. Help to remove stigma
 Examine contacts of diagnosed cases for presence of hypo pigmented
patch, thick/ tender nerve
 Keep record of suspected cases and cases under treatment
chn p.pptx

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chn p.pptx

  • 1.
  • 2.  a contagious disease that affects the skin, mucous membranes, and nerves, causing discoloration and lumps on the skin and, in severe cases, disfigurement and deformities.  Leprosy is now mainly confined to tropical Africa and Asia. causes: Leprosy is caused by a slow-growing type of bacteria called Mycobacterium leprae
  • 3. Tuberculoid leprosy Borderline tuberculoid leprosy Borderline borderline leprosy Borderline lepromatous leprosy Lepromatous leprosy
  • 4.
  • 5.
  • 6.
  • 7.  Paucibacillary Leprosy (PB) : skin lesions with no bacilli seen in the skin smear  Multibacillary Leprosy (MB): skin lesions with bacilli seen in the skin smear
  • 8.  Discolored patches of skin, usually flat, that may be numb and look faded (lighter than the skin around)  Growths (nodules) on the skin.  Thick, stiff or dry skin.  Painless ulcers on the soles of feet.  Painless swelling or lumps on the face or earlobes.  Loss of eyebrows or eyelashes.
  • 9.  Examine skin  Check for patches  Test for sensation  Count the number of patches  Look for damage to nerve
  • 10.  In 1941, promin introduced,but painful injections.  In 1950s, Dapsone pills, but resistance developed.  In 1981, WHO recommends multi drug treatment (MDT): Dapsone, Rifampicine, Clofazimine  Patients under treatment should be monitored for drug side-effects, leprosy reactions and for development of trophic ulcers
  • 11. Steps to start MDT  Classify as PB or MB leprosy  Inform patient about the disease.  Explain the MDT blister pack - show drugs to be taken once a month and every day  Explain possible side effects (e.g. darkening of skin) and possible complications and when they must return to the health centre  Give enough MDT blister packs to last until the next visit.  Fill out the patient treatment card
  • 12.  The National Leprosy Control Programme (NLCP) an been started since 1955 In 1983 Government of India redesignated into Leprosy Eradication Programme and introduced multidrug theraphy (MUT).  The World Health Assembly in May 1991 adopted a resolution for global leprosy elimination as public health problem by the year 2000 After the declaration of the global target was reset for the remaining 15 countries to achieve elimination at the national level creating by the end of December, 2015.  India was one of these level for countries. The National Health Policy of India 2002 also through set the goal of leprosy elimination in India by the end of -Samooh, year 2005.
  • 13. • enumerates the strategies of NLEP • discuss MDT explains the strategies for NLEP • states the organization of NLEP • describe the roles of key persons • enumerate the infrastructure
  • 14.  list the institute involved in anti-leprosy activities  discuss Modified leprosy elimination campaign  explains NLEP action plan, strategies and indicators  describes the DPMR  list nurses responsibility
  • 15.  1948-hind kusht nivaran sangh  1955- govt. of India launched NLCP  1983- launched NLEP and introduced MDT for treatment  1991- WHO declaration to eliminate leprosy at global level by 2000  1993-2000 World bank supported NLEP 1st
  • 16.  2001-2004 World bank supported NLEP 2nd  2005 national program continues with GOI funds  2005 - India achieved elimination of leprosy at national level December 05  Sponsored by central government  Funding pattern central government  Ministry / department - DGHS✓Beneficiaries-individual and community  Eligibility criteria anyone
  • 17.  Early case detection  Short term multi drug therapy  Health education  Rehabilitation services
  • 18.  Identifying case detection and MDT coverage in high prevalence states and areas difficult to access  Strengthening laboratory services PHC/CHC, establishing surveillance  Preparing for and initiating horizontal integration of leprosy program in to primary health care system • Providing greater emphasizes on disability prevention and treatment •Implementation of modified leprosy elimination campaign • Ensuring rehabilitation of cured patients
  • 19. ■ Early detection of leprosy cases ■ Intensified health education and public awareness campaigns ■ Regular treatment of leprosy cases providing multi- drug therapy( MDT) at fixed centers near the patient ■ Disability prevention and medical rehabilitation
  • 20.  Center level: DGHS and NLEP officer [NLEP commissioner for planning and policy ]  State level : director of health and services and state NLEP officer  Regional level: Regional NLEP officer [Leprosy control unit, Survey education and treatment, and Urban leprosy unit ]
  • 21. 1. The leprosy control units 2. Survey education and treatment centers 3. Urban leprosy centers
  • 22.  These are established in endemic areas with one medical officer 2 non- medical supervisor and 20 para medical worker .Each unit covering a population of 4.5 lakhs, each paramedical workers covers a population of 15 to 20000 and is expected to examine at least 8000 persons per year
  • 23. the team consists of one paramedical workers for 20 25000 population. One medical supervisor for every 5 paramedical workers. these centers attached to PHCS
  • 24. One established for every 30-40 thousand population. At central level, the leprosy division of the directorate general of health services, New Delhi is responsible for planning, supervision and monitoring of program
  • 25. ■ Late detection of patients, many with visible deformities ■ Poor treatment completion and cure ■ Fear, prejudice and stigma surrounding leprosy ■ Limited community awareness and involvement
  • 26. Find the source of infection  Assist in the examination of household contacts especially children  Education on the early sign and symptoms of leprosy  Help the patients and family to understand the nature of disease  Observe all patients in clinic Educate patients on care of feet, skin, eyes et
  • 27. Educate members of family and community by imparting correct knowledge.  Dispel misconception, misbeliefs. Help to remove stigma  Examine contacts of diagnosed cases for presence of hypo pigmented patch, thick/ tender nerve  Keep record of suspected cases and cases under treatment