HIV/AIDS

TUBERCULOSIS

LEPROSY

MALARIA

Leprosy - Facts

Introduction

     The NLEP program was was started in state from 1978 and the program was initiated as the National Leprosy Control Program . However from 1983 onwards it became a 100% CSS and redesignated as National Leprosy Control Program.

Aim

To eradicate the disease from the country by 2000 A. D.

Objective

          To detect all hidden cases of Leprosy.

          To impart training to all general health care staff in order to facilitate
          integration of leprosy program in to primary health car
e.

          To provide health education to build awareness & to remove stigma
          associated with leprosy.

Administration Setup

     In order to implement the M.D.T. Schemes effectively, district leprosy societies were formed in 1994 in all districts of sikkim under the chairmanship of district collector.
State leprosy society was formed in 2001 under the direction of G. O. I. in order to co-ordinate all activities of the district societies and to implement the schemes efficiently.

State Leprosy Officer (S. L. O.)

State Leprosy Society Program Officer
  B. F. O. (Budget Finance Officer)
  D. E. O. ( Data Entry Operator)
District Leprosy Society D. L. O. (District Leprosy Officer)
  N. M. L. O. (Non Medical Leprosy Officer)
  P. M. W. (Para Medical Workers)

 

Objective Performance Of NLEP Wing For The Last 5 Years

Year No. of  old Cases Brought Forward New Cases Detected & Treated Annual Cases Discharged Total Balance After Discharge Prevalence Rate PR/10,000.
1998-99 98 85 73 110 2.70
1999-00 103 27 86 44 1.10
2000-01 44 46 40 50 1.20
2001-02 50 73 55 68 1.22
2002-03 68 40 67 41 0.75
2003-04 41 31 27 45 0.83

Information For General Public

Leprosy is a disease like any other disease . It is neither hereditary nor due to any sin or curse
It is chronic infectious disease caused by bacteria named MYCOBACTERIUM LEPRAE. lepra_bacteria.jpg (17165 bytes)


     Leprosy, a disease as old as mankind, has been a public health problem to many developing countries, including India. It is one of the common most disabling diseases with many wrong notions attached.

In the past, people related leprosy to a curse of God, past Sins, Hereditary factor etc. A few patients develop deformities in the course of the disease due to structural damage. Because of these deformities, patients are socially isolated. This affects the person's social and economic well being. It is estimated that there are 12 million leprosy affected people world wide.

lepra_bacteria.jpg (17165 bytes)The Cause
     Leprosy is caused by a Bacterium called Mycobacterium leprae, a microscopic germ. It principally affects nerves, skin and later other organs of the body. The germs mostly spread through coughing and sneezing.

More about the Disease
      Leprosy usually starts as a slightly light coloured patch without any feeling for pain, touch or temperature. The patch can be found anywhere in the body. Nerves near to these patches and at the joints are swollen when affected. In majority of patients, the disease progresses without any deformity. In a few patients the involved nerve becomes damaged.

When improperly treated, the nerve damage is severe and may lead to deformities of hands, feet and eyes. These deformities occur due to loss of sensation and a break in the communication between nerves and muscles. As the muscles lose control and nutrition from the nerves, they become smaller in size and paralyzed.

The fingers and toes appear like a claw. Loss of sensation results in unusual injuries and ulcers. Eyes are affected in a few patients with prolonged disease.

Only 10% of patients (those with more widespread disease) are actually infectious if left untreated.

Even these patients, after two weeks of drug therapy cease to spread the disease.

The Immunity
     Immunity (commonly referred to as resistance of the body) is the factor, which decides whether one can catch the disease. Most people are naturally resistant to the leprosy bacteria and hence remain healthy.

Some facts

  • Leprosy can effect all ages and both sexes.

  • The disease has a very long period of incubation of Latency running into several years. Most often the incubation period is between 3 to 5 years. Leprosy is an infectious disease directly transmitted from man to man. However, it is acquired through prolonged exposure and only a small proportion of the population is effected.

  • Leprosy is transmitted from one untreated person to another via respiratory tract and skin.

Misconceptions, Prejudices & Malpractices

  • Some people still believe that Leprosy occurs due to

    • Heredity

    • Immoral behaviour

    • Impure blood

    • Faulty eating habits such as dried fish.

    • Past signs, etc.

  • People think Leprosy spreads in some families only. It can be contacted by mere touch.

  • Leprosy is often associated with deformity. Leprosy can be diagnosed  only after deformity.

  • Leprosy is highly infectious and infectivity is associated with deformity.

  • Leprosy is incurable.

  • Children,in families having a Leprosy patient always develop Leprosy.

  • Some unhealthy practices seen in society

    • Shunning away from Leprosy patient.

    • Social boycotting, keeping social distance from family having leprosy patients.

    • Social harassment of the patient and members of his family.

    • Refusal to help a patient of Leprosy.

    • Disinclination to know about the disease and lack of cooperation with Leprosy workers.

  • All beggar Leprosy cases and patients with deformity and Ulcer spread the disease.

Present Trends in Leprosy

Leprosy is now curable.
     In the past, there were no medicines, and the disease often progressed resulting in severe deformities  and disabilities. In 1940, there was a breakthrough with the discovery of Dapsone, an anti-biotic affective against the Leprosy germ. Later, more drugs were discovered and a multi-drug regimen, popularly known as MDT ( Multi- Drug Therapy) was introduced in early eighties. MDT cures Leprosy quickly and effectively.

Active Leprosy surveys have been intensified since the introduction of MDT detecting patients in the initial stages of the disease. Now -a- days the disease can be cured within 6-12 months. These two factors have led to the decrease in the amount of deformities. Proper and timely treatment of nerve damage can now prevent deformities in this low proportion of patients.

Advantages of MDT

  • Highly effective in curing the disease

  • Reduce 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.

Essentials of the Elimination Strategy, The main thrust of the strategy to eliminate leprosy is to :

  • Expand MDT services to all health facilities

  • Ensure that all existing and new cases are given appropriate MDT regimens

  • Encourage all patients to take treatment regularly and completely

  • Promote awareness in the community about leprosy so that individuals with suspicious lesions will report voluntarily for diagnosis and treatment

  • Set targets and time-table for activities and make all efforts to achieve them

  • Keep good records of all activities in order to monitor the progress towards elimination.

Preparatory Activities

  • Plan of Action

  • Mobilization of resources

  • Organization of MDT services

Core Activities

  • Updating of registers

  • MDT implementation

  • Treatment compliance and completion

  • Case-detection

  • Disability prevention and management

Evaluating Activities

  • Programme monitoring and evaluation

  • Epidemiological surveillance

Supportive Activities

  • Patient and family counseling

  • Community education

  • Referral System

  • Promotion of social and economic integration

How to increase awareness in the community
     The signs of the leprosy are usually minimal in the early stages. Some times the patient may report the disease only at a later stage when it is obvious. The following activities may help in early reporting of the disease.

  • Informing the community about the signs and symptoms of leprosy, strongly stressing that it is curable disease, and encouraging patients to seek treatment without delay

  • Informing about locations and timing of available services

  • Informing about the availability of free treatment

  • Informing that starting treatment without delay will prevent disabilities

  • Requesting the local community leaders, teachers, religious authorities to participate in health education activities

  • Using the local newspaper/ radio/ TV to inform about leprosy

  • Organizing special campaigns

 

 

          NATIONAL LEPROSY ERADICATION PROGRAMME PHYSICAL TARGET AND ACHIEVEMENT
          DURING 1997 -98 TO 2001-2002

  NEW CASES DETECTED NEW CASES BROUGHT UNDER TREATMENT CASES DISCHARGED
YEAR TARGET ACH % TARGET ACH % TARGET ACH %
                   
                   
                   
                   
                   
                 

 

     Source: NLEP Cell, H & F.W. Department.

 

 
 

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