The document presents information on the National Leprosy Eradication Programme (NLEP) in India. It discusses the classification and diagnosis of leprosy, the objectives and strategies of NLEP, and the roles of ASHA workers and community health nurses in supporting treatment, disability prevention, and raising awareness of leprosy in communities. Key milestones of NLEP include the introduction of multidrug therapy in 1983 and integration with general health services. NLEP aims to eliminate leprosy at the national level through early detection, treatment, and health education.

1. PRESENTATION ON
NATIONAL LEPROSY ERADICATION
PROGRAMME (NLEP)
Submitted to :-
Mrs.Bina Barla Madam
Associate Professor
College of Nursing
RIMS RANCHI
Submitted by :-
Kri.Kavita Soren
Roll no.-06
Basic b.sc nursing
4th year
College of Nursing
Date :- 02/02/2021

2. CONTENT
• INTRODUCTION
• CLASSIFICATION OF LEPROSY
• NATIONAL LEPROSY ERADICATION PROGRAMME
• MILESTONES OF NLEP
• CURRENT DIAGNOSIS UNDER NLEP
• OBJECTIVES
• STRATEGIES
• ELIMINATION STRATEGIES
• CURRENT ACTIVITIES UNDER NLEP
• INVOLVEMENT OF NGO
• DISABILITY PREVENTION & MEDICAL REHABILITATION PLAN
• NEW INITIATIVES
• INVOLVEMENT OF ASHA
• ACTIVITIES TO BE PERFORMED BY ASHA
• ANTI LEPROSY ACTIVITIES IN INDIA
• THE NLEP EMBLEM
• ROLE OF COMMUNITY HEALTH NURSE IN NLEP
• RESOURCES USED
• BIBLIOGRAPHY

3. • LEPROSY IS A CHRONIC INFECTIOUS DISEASE CAUSED BY ‘MYCOBACTERIUM LEPRAE’ AN
ACID FAST , ROD SHAPED BACILLUS.
• THE DISEASE MAINLY AFFECTS THE SKIN , THE PERIPHERAL NERVES , MUCOSA OF THE
UPPER RESPIRATORY TRACT AND ALSO EYES.
• CARDINAL FEATURES:-
° HYPOPIGMENTED PATCH
° LOSS OF CUTANEOUS SENSATION
° THICKENED NERVE
° ACID FAST BACILLI
• LEPROSY HAS BEEN REGARDED BY TBE COMMUNITY AS A CONTAGIOUS , MUTILATING
AND INCURABLE DISEASE.
• LEPROSY IS CURABLE AND TREATMENT PROVIDED IN THE EARLY STAGES AVERTS
DISABILITY.
• MULTIDRUG THERAPY (MDT) TREATMENT HAS BEEN MADE AVAILABLE BY WHO FREE OF
CHARGE TO ALL PATIENTS WORLDWIDE SINCE 1995, AND PROVIDES A SIMPLE YET HIGHLY
EFFECTIVE CURE FOR ALL TYPESOF LEPROSY.

4. CLASSIFICATION OF LEPROSY
• LEPROSY CAN BE CLASSIFIED ON THE BASIS OF CLINICAL MANIFESTATIONS AND SKIN
SMEAR RESULTS :-
1. PAUCIBACILLARY LEPROSY (PB)
2. MULTIBACILLARY LEPROSY (MB)
1.PAUCIBACILLARY LEPROSY (PB):- PATIENT SHOWING NEGATIVE SMEARS AT ALL SITES
ARE
GROUPED AS PAUCIBACILLARY LEPROSY (PB).
2.MULTIBACILLARY LEPROSY (MB) :- PATIENT SHOWING POSITIVE SMEARS AT ANY SITE
ARE
GROUPED AS HAVING MULTIBACILLARY LEPROSY (MB).

5. NATIONAL LEPROSY ERADICATION
PROGRAMME
LEPROSY IS A DISEASE OF PUBLIC HEALTH CONCERN BECAUSE OF ITS POTENTIAL NATURE
OF CAUSING DISABILITY AND THE SOCIAL STIGMA AND DISCRIMINATION ATTACHED TO
IT. IN INDIA , 86000 CASES WERE ON RECORD AS ON APRIL 1, 2014 . THE PREVALANCE
RATE OF LEPROSY WAS 0.68 PER 10,000 POPULATION IN 2014 . IN 1955 , INDIA
LAUNCHED THE NATIONAL LEPROSY CONTROL PROGRAM ( NLCP) WITH THE FEATURES OF
CASE DETECTION , TREATMENT WITH DAPSONE AND COMMUNITY EDUCATION. THIS WAS
CHANGED TO THE NATIONAL LEPROSY ERADICATION PROGRAM (NLEP) IN 1983, WITH THE
INTRODUCTION OF MULTIDRUG THERAPY (MDT).

6. IMPORTANT MILESTONES IN NLEP IN INDIA
• 1848 : LEPAR ACT, BRITISH INDIA ABOLISHED LATER
• 1948 : HIND KUSHT NIVARAN SANGH
• 1955 : NATIONAL LEPROSY CONTROL PROGRAM
• 1980 : DAPSONE
• 1983 : GOVERNMENT OF INDIA LAUNCHED NLEP AND INTRODUCED MDT.
• 1991 : WORLD HEALTH ASSEMBLY RESOLUTION TO ERADICATE LEPROSY BY 2000AD
• 1998-2004 : MODIFIED LEPROSY ELIMINATION PROGRAM
• 1993-2000 : WORLD BANK SUPPORTED NLEP -1
• 2001-2004 : WORLD BANK SUPPORTED NLEP -2
• 2005 : NLEP CONTINUED WITH GOVERNMENT OF INDIA FUNDS AND DONER PARTNER
SUPPORT.
• 2005 : NRHM COVERS NLEP.
• 2012 : SPECIAL ACTION PLAN FOR 209 HIGH ENDEMIC DISTRICTS 16 STATE /UTS.

7. ULATION
CURRENT STATUS

8. OBJECTIVES
• TO ACHIEVE ELIMINATION OF LEPROSY OF NATIONAL LEVEL BY THE END OF THE
PROJECT.
• TO ACCOMPLISH INTEGRATION OF LEPROSY SERVICES WITH THE GENERAL
HEALTH CARE SYSTEM IN THE 27 LOW ENDEMIC STATES /UTS.
• TO PROCEED WITH INTEGRATION OF SERVICES OF SERVICES AS RAPIDLY AS
POSSIBLE IN THE 8 HIGH ENDEMIC STATES.

9. STRATEGIES
• DECENTRALIZATION OF NLEP TO STATES AND DISTRICTS .
• INTEGRATION OF LEPROSY SERVICES WITH GENERAL HEALTH CARE SYSTEM
(GHS).
• LEPROSY TRAINING OF GHS FUNCTIONARIES.
• EARLY DIAGNOSIS AND PROMPT MDT , THROUGH ROUTINE AND SPECIAL
EFFORTS.
• INFORMATION EDUCATION AND COMMUNICATION (IEC) USING LOCAL AND
MASS MEDIA FOR REDUCTION OF STIGMA AND DISCRIMINATION
• PREVENTION OF DISABILITY AND MEDICAL REHABILITATION.
• MONITORING AND PERIODIC EVALUATION.
• INTER-SECTORAL COLLABORATION.

10. ELIMINATION STRATEGY
TO ELIMINATE LEPROSY THE GOVERNMENT OF INDIA HAS ACCEPTED MODIFIED
LEPROSY ERADICATION COMPAIGNS (MLEC) AND SPECIAL ACTION PROJECT FOR
THE ELIMINATION OF LEPROSY (SAPEL) STRATEGIC ACTION FOR THE EARLY
DETECTION OF LEPROSY CASES AND MASS AWARENESS.

11. 1. MODIFIED LEPROSY ELIMINATION
COMOAIGNS (MLEC )
• THE MLEC APPROACH IS ACTUALLY ORGANIZING CAMPS FOR ONE OR TWO
WEEKS DURATION IN WHICH SERVICES LIKE CASE DETECTION , TREATMENT AND
REFERRAL TO RECONSTRICTION FACILITIES ARE AVAILABLE.
• CARRIED OUT DURING 1997 -1998 TO 2003-2005
• HELPED IN BRINGING OUT 9.9 LAKH NEW CASES UNDER TREATMENT IN A SHORT
SPAN OF TIME
• HELPED IN INCREASING LEPROSY AWARENESS AMONG THE MASSES.

12. 2. SPECIAL ACTION PROJECTS FOR THE
ELIMINATION OF LEPROSY (SAPEL)
SAPEL IS AN IN INITIATIVE AIMED AT PROVIDING MDT SERVICES TO PATIENTS
LIVING IN SPECIAL DIFFICULT TO ACCESS AREAS OR SITUATION OR TO THOSE
BELONGING TO NEGLECTED POPULATION GROUPS . THE MOST IMPORTANT THING
IS FOR THE ELIMINATION PROGRAM TO REACH SERVICES.

13. CURRENT ACTIVITIES UNDER NLEP
• DIAGNOSIS AND TREATMENT OF LEPROSY.
* MDT PROVIDED TO ALL PHC’S FREE OF COST
* DIFFICULT TO DIAGNOSE CASES & COMPLICATED CASES REFERRED TO
DISTRICT
HOSPITALS
* ASHAS UNDER NRHM HELPS BRING OUT LEPROSY CASES FROM VILLAGES
FOR
DIAGNOSIS AND TREATMENT COMPLETION

14. EARLY DETECTION OF LEPROSY
*FOR THE FIELD PURPOSE:
• MULTI –BACILLARY LEPROSY IS LABELED WHEN THERE ARE 6 OR MORE SKIN
PATCHES
AND /OR 2 OR MORE NERVES AFFECTED . SKIN SMEAR IS POSITIVE.
• PAUBACILLARY LEPROSY IS LABELED WHEN THERE 5 OR LESS THAN 5 SKIN
LESIONS AND
/OR 1 MORE NERVE AFFECTED . SKIN SMEAR DO NOT SHOW BACILLI.

15. TREATMENT
• RIFAMPICIN IS GIVEN ONCE A MONTH . NO TOXIC EFFECTS HAVE BEEN REPORTED IN THE CASE OF MONTHLY
ADMINISTRATION . THE URINE MAY BE COLOURED SLIGHTLY REDDISH FOR A FEW HOURS AFTER ITS INTAKE ,
THIS SHOULD BE EXPLAINED TO THE PATIENT WHILE STARTING MDT.
• CLOFAZIMINE IS MOST ACTIVE WHEN ADMINISTERED DAILY . THE DRUG IS WELL TOLERATED AND VIRTUALLY
NON-TOXIC IN THE DOSAGE USED FOR MDT. THE DRUG CAUSES BROWNISH BLACK DISCOLURATION AND
DRYNESS OF SKIN . HOWEVER , THIS DISAPPEARS WITHIN FEW MONTHS AFTER STOPPING TREATMENT. THIS
SHOULD BE EXPLAINED TO PATIENTS STARTING MDT REGIMEN FOR MB LEPROSY.
• DAPSONE: THIS DRUG IS VERY SAFE IN THE DOSAGE USED IN MDT AND SIDE EFFECTS ARE RARE. THE MAIN
SIDE EFFECTS IS ALLERGIC REACTION , CAUSING ITCHY SKIN RASHES AND EXFOLIATIVE DERMATITIS .
PATIENTS KNOWN TO BE ALLERGIC TO ANY OF THE SULPHA DRUGS SHOULD NOT BE GIVEN DAPSONE.
• MULTIBACILLARY (MB)LEPROSY.
FOR ADULTS THE STANDARD REGIMEN IS : RIFAMPICIN :600MG ONCE A MONTH DAPSONE: 100MG DAILY
CLOFAZIMINE : 300MG ONCE A MONTH AND 50 MG DAILY DURATION = 12MONTHS
• PAUCIBACILLARY (PB) LEPROSY.
FOR ADULTS THE STANDARD REGIMEN IS : RIFAMPICIN : 600 MG ONCE A MONTH DAPSONE : 100 MG
DAILY DURATION = 6 MONTHS
• SINGLE SKIN LESION PAUCIBACILLARY LEPROSY.
FOR ADULTS THE STANDARD REGIMEN IS A SINGLE DOSE OF : RIFAMPICIN : 600 MG OFLOXACIN : 400 MG
MINOCYCLINE : 100 MG

16. MONITORING AND EVALUATION
• THE IMPLEMENTATION OF ELIMINATION PLANS IN THE MOST ENDEMIC COUNTRIES IS
CLOSELY MONITORED SO AS TO DETECT POTENTIAL PROBLEMS THAT MIGHT IMPEDE
ITS PROGRESS AND TO IDENTIFY RAPID , YET FEASIBLE SOLUTIONS :
* PROMOTION OF RESEARCH IN THE EPIDEMIOLOGY OF THE DISEASE , INCLUDING
MODELLING
* DEVELOPMENT OF COMPUTERIZED DATABASES ON LEPROSY, INCLUDING DATA
COLLECTION , REPORTS AND ANALYSIS , ESTIMATES AND PREDICTIONS OF
LEPROSY PROBLEM
TRENDS
* COSTING AND DRUG REQUIREMENTS FOR THE ELIMINATION OF THE DISEASE
* DEVELOPMENT OF SIMPLIFIED TOOLS FOR DATA COLLECTION , INCLUDING
GUIDELINES AND TRAINING MATERIAL,ON
ESSENTIAL INFORMATION FOR THE CONTROL OF LEPROSY IN THE MOST ENDEMIC
COUNTRIES.

17. INVOLVEMENT OF NGO
• HELP TO REDUCE BURDEN OF LEPROSY
• SERVE IN REMOTE , INACCESSIBLE , UNCOVERED , URBAN SLUMS , INDUSTRIAL
/LABOUR POPULATIONS AND OTHER MARGINALIZED POPULATION GROUPS.
• SER ( SURVEY EDUCATION AND TREATMENT) SCHEME.

18. DISABILITY PREVENTION AND MEDICAL
REHABILITATION PLAN
OBJECTIVES OF THE REHABILITATION PLAN :
1. PERSON WITH LEPRA REACTIONS ARE ADEQUATELY MANAGED SO AS TO PREVENT
OCCURANCE OF DISABILITIES.
2. PERSONS WITH DISABILITIES DUE TO LEPROSY ARE ASSISTED WITH CARE AND
SUPPORT TO
PREVENT WORSENING OF THEIR EXISTING DISABILITIES.
3. PERSON WITH DEFORMITIES SUITABLE FOR CORRECTION ARE PROVIDED
RECONSTRUCTIVE
SURGERY SERVICES THROUGH SPECIALIZED CENTERS MANAGED BY GOVERNMENT
AND
VOLUNTARY ORGANIZATIONS.

23. ACTIVITIES TO BE PERFORMED BY ASHA
• SEARCH FOR SUSPECTED CASES OF LEPROSY.
• FOLLOW UP ALL CASES FOR COMPLETION OF TREATMENT IN SCHEDULE TIME.
• ADVICE AND MOTIVATE SELF CARE PRACTICES BY DISABLED CASES FOR PROPER
CARE OF THEIR HANDS AND FEET DURING THE FOLLOW UP PERIOD.
• SPREADING AWARENESS.
• RECORD OF CASES REFERRED BY ASHAS WILL BE MAINTAINED PROPERLY AND
INCENTIVE WILL BE PAID ON TIME AND REGULAR MONTHLY REPORT WILL BE
SUBMITTED TO THE DISTRICT LEPROSY OFFICER.

27. ROLE OF COMMUNITY HEALTH NURSE IN
NLEP
• EDUCATE COMMUNITY ABOUT CAUSE,SPREAD,PREVENTION AND MANAGEMENT OF THE DISEASE.
• TRY TO ASSIST IN CHANGING THEIR MISPERCEPTIONS AND STIGMA ABOUT THE DISEASE.
• STRESS ON IMPORTANCE OF EARLY DETECTION OF THE DISEASE THAT HELPS IN PREVENTION OF DEFORMITY.
• TEACH ON HOW DEFORMITIES ARE PREVENTED AND CONTROLLED.
• REGULAR EXAMINATION OF SKIN SURFACES AND REPORT IF ANYTHING NEW OR ABNORMAL. PARTICULARLY CONTACTS
MUST BE ALERTED ON THIS.
• ADVISE THE CASE TO TAKE MDT REGULARLY AS ADVISED.
• INDIVIDUAL /GROUP/ MASS EDUCATION SHOULD BE CONDUCTED.
• FOLLOW UP THROUGH HOME VISITS-IDENTIFY AND ADVISE ON REGULAR TREATMENT .IF NEEDED DRUGS CAN BE SUPPLIED
AT HOME.
• PATIENTS WITH ANY COMPLICATIONS SHOULD BE REFERRED TO PHC.
• REFER FOR DISABILITY PREVENTION AND MEDICAL REHABILITATION (DPMR)

28. RESOURCES USED
• COMMUNITY HEALTH NURSIN BOOK
• INTERNET
• CONSULT WITH TEACHER

29. BIBLIOGRAPHY
• MANIVANNAN D SHYAMALA,” TEXTBOOK OF COMMUNITY HEALTH
NURSING2”,CBS
PUBLISHERS &DISTRIBUTORS PVT LTD, PAGE NO;241-243
• WWW.SLIDESHARE.NET.IN
• WWW.WIKIPEDIA.ORG
• WWW.SCRIBD.COM