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| SHORT COMMUNICATION |
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| Year : 2023 | Volume
: 8
| Issue : 1 | Page : 20-21 |
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Sustaining and augmenting the pace of ongoing prevention and control activities to attain the goal of leprosy-free world
Saurabh RamBihariLal Shrivastava1, Prateek Saurabh Shrivastava2
1 Deputy Director – Academics, Sri Balaji Vidyapeeth – Deemed to be University, Medical Education Unit Coordinator and Member of the Institute Research Council, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Nellikuppam, Chengalpattu District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpattu District, Tamil Nadu, India
| Date of Submission | 12-Dec-2022 |
| Date of Decision | 31-Dec-2022 |
| Date of Acceptance | 23-Jan-2023 |
| Date of Web Publication | 30-Mar-2023 |
Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth - Deemed to be University, Tiruporur, Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpattu - 603 108, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ed.ed_29_22
Leprosy is a chronic infectious disease, predominantly affecting the skin and peripheral nerves, and is completely curable with multidrug therapy. Considering the global estimates, there is no doubt that disease-related control activities have significantly improved in endemic nations due to the campaigns at different levels and the integration of the disease-specific activities with the general health services, as a result of which diagnostic and therapeutic aspects of the disease have improved. A number of global strategies have been launched by the World Health Organization to support all nations to strengthen their routine prevention and control activities. In conclusion, leprosy is a major public health concern in endemic nations and there is an immense need to improve the detection rates and ensure the expansion of the treatment. In addition, there is a great need to empower the affected people, to eventually improve their integration into society.
Keywords: Case finding, India, leprosy, World Health Organization
How to cite this article:
Shrivastava SR, Shrivastava PS. Sustaining and augmenting the pace of ongoing prevention and control activities to attain the goal of leprosy-free world. Environ Dis 2023;8:20-1 |
How to cite this URL:
Shrivastava SR, Shrivastava PS. Sustaining and augmenting the pace of ongoing prevention and control activities to attain the goal of leprosy-free world. Environ Dis [serial online] 2023 [cited 2023 Jun 3];8:20-1. Available from: http://www.environmentmed.org/text.asp?2023/8/1/20/372863 |
| Introduction | |  |
Leprosy is a chronic infectious disease, predominantly affecting the skin and peripheral nerves, and is completely curable with multidrug therapy (MDT).[1] Initiation of the therapy in the early stages of the disease neutralizes the risk of disability, while the untreated form can result in progressive and permanent damage to the affected organs.[1] The global estimates for the year 2020 revealed that 0.13 million new cases of the disease were reported across 139 nations.[1] Further, it was reported that almost 6% of the incident cases were detected with second-grade disabilities. Moreover, the coronavirus disease 2019 pandemic disrupted the implementation of the program and brought about a reduction in the detection of new cases by 37% in the year 2020 when compared with the estimates from the previous year.[1]
| Progress Made and the Way Forward | | |
Considering the global estimates, there is no doubt that disease-related control activities have significantly improved in endemic nations due to the campaigns at different levels and the integration of the disease-specific activities with the general health services, as a result of which diagnostic & therapeutic aspects of the disease have improved.[1],[2] In fact, the real gain achieved is due to the global approach envisaged in the enhanced global strategy for 2011-2015 (under which it was aimed to detect all cases in the community and ensure completion of MDT), and global leprosy strategy for 2016-2020 (the strategy advocated for enhancing the number of skilled leprosy staff, improving community awareness about the disease, and to minimize visible deformities & stigma attributed with the disease).[2],[3]
| Moving Forward Toward Zero Leprosy | | |
The Global Leprosy Strategy for 2021-2030 has proposed a long-term vision wherein we aim to attain zero leprosy(in terms of infection and incidence), zero disability, and zero stigmas and discrimination.[1] In order to attain these goals, we must implement integrated roadmaps, which necessarily include sustained political commitment, multisectoral involvement, capacity-building services, strengthening of surveillance mechanisms and improved data management, and systematic monitoring of antimicrobial resistance and adverse drug reactions.[1],[2] In addition, there is an indispensable need to scale up routine prevention activities, including contact tracing, chemoprophylaxis, and active case-finding strategies.[3],[4],[5],[6] Moreover, we cannot move ahead unless specific measures are taken to appropriately manage leprosy cases and thereby minimize the development of disability, and this will depend on early case detection, improvement in referral services, correct diagnosis and treatment of lepra reactions, training of people in self-care, and promotion of mental well-being of diagnosed cases through counseling.[3],[7] At the same time, we have to adopt specific measures to reduce the potential of stigma and ensure that basic human rights are safeguarded and well-respected.[8]
| Additional Interventions for Leprosy Control | | |
Apart from the global strategy, the World Health Organization also released a manual for the effective management of lepra reactions and prevention of infection-induced disabilities.[1] Considering the fact that almost 50% of the reported cases might report lepra reactions, it is quite essential that healthcare workers are trained to detect and effectively manage these reactions. Any delay or absence of treatment might account for the occurrence of permanent and progressive disabilities.[1],[3],[4],[7] In addition, a specific guide has also been released to provide recommendations for different nations about ways to implement contact screening and chemoprophylaxis with single-dose rifampicin.[4],[5]
| Conclusion | | |
Leprosy is a major public health concern in endemic nations and there is an immense need to improve the detection rates and ensure the expansion of the treatment. In addition, there is a great need to empower the affected people, to eventually improve their integration into society.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | |
| 2. | Shukla LK, Patel RN, Patel SV, Baxi RK. Evaluation of the effect of block level awareness campaign on performance indicators of National Leprosy elimination program in Vadodara district, Gujarat, India. Indian J Dermatol Venereol Leprol 2015;81:257-62.  [ PUBMED] [Full text] |
| 3. | Lazo-Porras M, Prutsky GJ, Barrionuevo P, Tapia JC, Ugarte-Gil C, Ponce OJ, et al. World Health Organization (WHO) antibiotic regimen against other regimens for the treatment of leprosy: A systematic review and meta-analysis. BMC Infect Dis 2020;20:62. |
| 4. | Alemu Belachew W, Naafs B. Position statement: LEPROSY: Diagnosis, treatment and follow-up. J Eur Acad Dermatol Venereol 2019;33:1205-13. |
| 5. | Aamir M, Sadaf A, Khan S, Perveen S, Khan A. Recent advancement in the diagnosis and treatment of Leprosy. Curr Top Med Chem 2018;18:1550-8. |
| 6. | Pedrosa VL, Dias LC, Galban E, Leturiondo A, Palheta J Jr., Santos M, et al. Leprosy among schoolchildren in the Amazon region: A cross-sectional study of active search and possible source of infection by contact tracing. PLoS Negl Trop Dis 2018;12:e0006261. |
| 7. | Chukwu JN, Ekeke N, Nwafor CC, Meka AO, Alphonsus C, Mbah OK, et al. Worsening of the disability grade during leprosy treatment: Prevalence and its determinants in Southern Nigeria. Trans R Soc Trop Med Hyg 2018;112:492-9. |
| 8. | The Lancet. Abandoning the stigma of leprosy. Lancet 2019;393:378. |
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