The Hindu
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Saturday, Feb 04, 2006

Opinion

A battle won
http://www.hindu.com/2006/02/04/stories/2006020403621100.htm

Aarti Dhar

The prevalence rate of less than 1 per 10,000
population is a significant
milestone for India in its fight against leprosy.

ON DECEMBER 31, 2005, India achieved the globally
defined prevalence rate of
less than 1 per 10,000 population, a milestone in
eliminating leprosy. From
accounting for 70 per cent of the world's leprosy
cases in the 1950s, the
country has brought down the prevalence rate to 0.95
per 10,000 over the
next five decades.

There is no place for complacency. The anti-leprosy
programme has to
continue at its present intensity to reduce the
prevalence rate in areas
that are yet to achieve the target. This will help
avoid any possible
recurrence of the disease in areas where success has
already been achieved,
and ultimately lead to its total eradication.

In May 1991, the World Health Assembly adopted a
resolution for global
leprosy elimination by 2000. In 2001, after the target
was achieved, it was
reset to December 2005 for the remaining 14 countries.
India was one of the
14 countries that also included Brazil, Madagascar,
and Nepal. The National
Health Policy 2002 also set the goal of leprosy
elimination in India by
2005.

There were 1.49 lakh leprosy cases on record in the
country on April 1,
2005, a prevalence rate of 1.34 per 10,000 population.
By December 2005, the
number of cases on record came down to 1.07 lakh, a
prevalence rate of 0.95
cases per 10,000 population. If official statistics
are to be believed, 24
States and Union Territories achieved the target set
by the World Health
Organisation by March 2005. Two more - Maharashtra and
Goa - were added to
the list by November.

Bihar, Chhattisgarh, Jharkhand, Orissa, Uttar Pradesh,
and West Bengal
continue to have a prevalence rate of between 1 and 3
per 10,000.

These six States, which account for 41 per cent of the
country's population,
contribute 60 per cent of the caseload.

The high prevalence rate in the major States is
attributed to the late
detection of leprosy cases. Since leprosy was
initially believed to be
endemic to southern States, particularly Tamil Nadu,
the Leprosy Control
Programme, begun in 1955, was concentrated in these
areas. All southern
States now have a very low prevalence rate though the
percentage of
disability due to the disease is high. The lowest
prevalence rate is in
Meghalaya, 0.11 per 10,000, followed by Manipur at
0.13 per 10,000. Tamil
Nadu has a prevalence rate of 0.69, Andhra Pradesh
0.62, Karnataka 0.65,
Kerala 0.31, and Pondicherry 0.27.

The National Leprosy Control Programme, begun in 1955,
became the National
Leprosy Eradication Programme in 1983. A significant
aspect of the programme
was the Five Modified Leprosy Elimination campaigns
carried out between 1998
and 2004 to generate awareness about the disease,
train health care workers,
and detect hidden leprosy cases in all the States and
Union Territories and
put them under Multiple Drug Therapy (MDT).

The campaigns helped detect close to 10 lakh leprosy
cases. In 2004-05, the
Government came up with a plan focussing on high
prevalence rate and
moderately endemic districts. It later shifted to the
block level under the
Focussed Leprosy Eliminated Plan launched in 2005.

The proportion of children afflicted by leprosy among
the new cases detected
stands at 10.2 per cent at the national level. Higher
proportions are
reported from Andhra Pradesh (12.2 per cent), Bihar
(16.2 per cent), Gujarat
(12.5 per cent), Jharkhand (12.7 per cent), Kerala
(12.5 per cent),
Maharashtra (12 per cent), Tamil Nadu (17.2 per cent)
and Pondicherry (16.1
per cent).

Analysis in these States has to be done at the block
level to take suitable
remedial actions.

Copyright © 2006, The Hindu.






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