It is a chronic infectious disease caused by M. leprae, which mainly affects the skin, peripheral nerves, and mucosa. It has left a legacy of social stigma. Global statistics from 2001 show South East Asia has the highest prevalence, with India reporting the most cases. The goal of leprosy programs is elimination by reducing prevalence to less than 1 per 10,000 by 2000, which can be achieved by making multi-drug therapy accessible and treating all cases to interrupt transmission. Diagnosis is based on skin lesions and sensory loss. Multi-drug therapy is highly effective and cures leprosy by treating for a fixed duration.

1. SHRI GUJARATI SAMAJ
S.K.R.P.G.H.M.C.H.R.C
SESSION-2017-2018
DEPARTMENT OF COMMUNITY MEDICINE
GUIDED BY:-
DR. NAVNEET SINGH(HOD)
SUBMITTED BY:-
SUMAYLA KHAN
PROFF- 4TH

2. LEPROSY
It is a chronic infectious disease caused by M.leprae,
an acid fast, rod shaped bacillus. It mainly affects the
skin, peripheral nerves, and mucosa of the
respiratory tract etc., It has left behind a terrifying
image in history and human memory of mutilation,
rejection and exclusion from society.

3. Global Leprosy Situation 1998

4. Leprosy Situation in South East Asia 2001
Thailand 2251 797 0.4 1.3
Country Point Prevalence Cases detected during the year 2001 Prevalence per 10000 Detection per 100000
Bangladesh 8537 10740 0.6 8.2
Bhutan 40 19 0.2 0.9
India 439782 617993 4.3 60.1
Indonesia 17259 13286 0.8 6.2
Myanmar 8237 9684 1.8 21.0
Nepal 10657 13830 4.4 56.5
Sri Lanka 1570 2309 0.8 12.1
Total 488333 668658 3.2 43.7

5. Global Leprosy Situation in 2001*
Region Point Prevalence Cases detected during the
year 2001
Africa 45170 39612
Americas 83101 42830
East Mediterranean 7007 4758
South East Asia 488333 668658
Western Pacific 7735 4786
Europe 38 53
World 635404 763317
* As reported by 106 countries.

6. Prevalence of Leprosy in SEA Region as of April 2001

7. GOAL AND OBJECTIVE OF LEPROSY
ERADICATION PROGRAMME
- Goal: elimination of leprosy i.e.to reduce the prevalence
rate to less than I per 10000 population by the year 2000
AD.
- Objective: To arrest disease activity in all the known cases
of leprosy by the year 2000AD
- Strategy: The elimination strategy

8. CONTROL OF LEPROSY
It means no longer to be a
public health problem

9. ERADICATION OF LEPROSY
It is defined as interruption of
transmission of leprosy to attain a stage of
zero level

10. - The elimination of leprosy as a public health means reducing the
prevalence of leprosy to below on case per 10000 population.
- Elimination of leprosy will be achieved by:
- Making MDT accessible to all communities and areas.
- Treating all registered cases with MDT
- Diagnosing and promptly treating all new cases
- Improving quality of patient care, including disability prevention and
management
- Ensuring reqularity and completion of treatment
- Enlisting community support for the programme
ELIMINATION OF LEPROSY

11. INCIDENCE OF LEPROSY
Incidence is the number of new cases
(only the new cases) of a particular disease
that occur in a defined population over a
defined period of time. The time period
used is conventionally one year.

12. PREVALENCE OF LEPROSY
1. Point Prevalence
2. Period Prevalence

13. Point Prevalence
The number of persons with a disease at a
specified point in time in a defined
Population

14. Period prevalence
The number of persons with a disease in a
defined population within a specified period of
time

15. SUSPECT CASE OF LEPROSY
- One or more suggestive skin patches with normal sensation
- Extensive loss of sensation in the hands or feet with no other
evidence of leprosy
- One or more grossly enlarged peripheral nerve trunks with no
sensory loss or skin lesion
- Painful nerves with no other evidence of leprosy
- Painless ulcers on hands and/or feet with no other evidence
of leprosy
- Nodules on the skin with no other evidence.

16. WHO IS LIKELY TO REPORT TO THE HEALTH CENTRE
- Leprosy cases who were never treated before
- Leprosy cases who had treatment with dapsone in the
past
- Leprosy cases who had treatment with MDT in the past
Suspect cases
- With other skin lesions
- Other conditions causing nerve damage
- Contacts of leprosy patients for check up
- Normal individual for information

17. How to examine for leprosy?
Examine in a well-lit room
Examine the whole body
Ask since when the patch was noticed
Ask what treatments have been tried
Test for sensation
Look for any visible deformities

18. How to diagnose leprosy
Examine skin
Check for patches
Test for sensation
Count the number of patches
Look for damage to nerves

19. DIAGNOSIS OF LEPROSY
- Hypopigmented or reddish skin lesion(s) with
definite loss of sensation
- Damage to the peripheral nerves, as
demonstated by loss of sensation
- Weakness of the muscles of hands, feet or face
- Positive skin smear

20. FLOW CHART FOR DIAGNOSIS AND
CLASSIFICATION
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21. Leprosy - one of the few diseases which can be eliminated
Leprosy meets the demanding criteria for
elimination
practical and simple diagnostic tools: can be
diagnosed on clinical signs alone;
the availability of an effective intervention to
interrupt its transmission: multidrug therapy
a single significant reservoir of infection:
humans.

22. Elimination strategy
- Providing domicillary MDT to all communities and
areas
- Breaking the chain of transmission by intensive case
detection and promptly treatment activities
- Improving quality of patient care, including
disability prevention and management
- Ensuring regularity and completion of treatment
- Encouraging and ensuring community participation
- Providing rehabilitation to the needy patients
- Organising health education to patients , their
families and community.

23. ADVANTAGES OF MDT
- Highly effective in curing the disease
- Reduces the period of treatment
- Well accepted by patients
- Easy to apply in the field
- Prevents development of drug resistance
- Interrupts transmission of infection
- Reduces risk of relapse
- Prevents disabilities
- Improves community attitude

24. POINTS ON MDT TREATMENT
- Every leprosy patient should receive tratment with more than one
antileprosy drug
- Standard MDT is very safe and effective
- It is available free of charge for leprosy patients
- Standard MDT is for a fixed duration
- At the completion of a full course of MDT the patient is cured
- Use clinical criteria to classify and decide the treatment regimen
- If in doupt of classification, give MB treatment regimen
- Active follow-up after completion of treatment is not necessary
- In case of relapse, re-treat with appropriate standard MDT regimen

25. Multi Drug Therapy

26. When treatment is completed
Congratulate the patient
Thank family/friends for their support
Reassure that MDT completely cures leprosy
Any residual lesions will fade away slowly
Show them how to protect anaesthetic areas and/or
disabilities
Encourage to come back in case of any problem
Tell that they are welcome to bring other members
of family or friends for consultation
Remove the patient’s name from the treatment
register

27. According to Official figures from 115 countries show the global registered prevalence of leprosy
at 189 018 at the end of March 2013 and, 232 857 reported new cases against 226 626 in 2012.
The global statistics show that 220 810 (95%) of new leprosy cases were reported from Asia and
Africa while only 5% of new cases are from the rest of the world.
Most countries that were previously highly endemic for leprosy have achieved elimination target
of < 1 case per 10,000 population at the national level and are intensifying their efforts at regional
and district levels.
Pockets of high endemicity still remain in some areas of many countries but a few are mentioned
as reference:
Angola, Bangladesh, Brazil, China, Democatic Republic of Congo, Ethiopia, India, Indonesia,
Madagascar, Mozambique, Myanmar, Nepal, Nigeria, Philippines, South Sudan, Sri Lanka, Sudan
and the United Republic of Tanzania.
Global Scenario
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The National Leprosy Eradication Programme is a centrally sponsored Health
Scheme of the Ministry of Health and Family Welfare, Govt. of India.
The Programme is headed by the Deputy Director of Health Services (Leprosy )
under the administrative control of the Directorate General Health Services Govt. of
India.
While the NLEP strategies and plans are formulated centrally, the programme is
implemented by the States/UTs.
The Programme is also supported as Partners by the World Health Organization,
The International Federation of Anti-leprosy Associations (ILEP) and few other Non-
Govt. Organizations.
National Leprosy Eradication Program
INDIA

29. PARTNERS
• WHO
• Novartis
• State Governments
• ILEP
• Nippon Foundation/SMHF
• Other NGOs

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