Despite Govt effort, leprosy eradication a tough challenge

By Vikas Vaidya

No matter the fact that India was declared ‘Leprosy-Free’ as long back as 2005, the demeaning disease seems to be assuming menacing proportions in the country, if the statistical details available from Nagpur District alone are to be taken as a measure. Government teams have found out as part of their work under National Leprosy Eradication Programme that the district has approximaterly 800 identified Leprosy patients, and the number is still growing, ‘The Hitavada’ has learnt authentically.

If this is the case of only one district, then the figure of identified leprosy patients across the country is bound to be mind-boggling, experts suspect.

In sharp contrast, the experts state that at this juncture, the whole of China has only 600 persons identified as afflicted by leprosy, thanks to the aggressive efforts of the Chinese authorities in the past some years.

As part of the National Leprosy Eradication Programme, the Leprosy Unit of the Department of Public Health at Nagpur sent out as many as 424 teams to various parts of Nagpur District to locate and identify leprosy patients. To the shock of everybody, they returned with information about 224 new cases. When this number is added to the already existing 653 leprosy patients, the district stares at a staggering 873 lepsory identified cases.

Dr M S Chahande, Assistant Director of Leprosy Unit at Nagpur told ‘The Hitavada’, “There are still a number of pockets in both rural and urban parts of the country in which new cases continue to be detected. Our 424 teams for Nagpur went from door to door for the survey. They examined 28,91,542 people and found 8,782 cases of suspected affliction. After undergoing detail medical examination a total of 224 new cases were detected. Since the disease is contagious, our teams will now administer a stipulated dosage of appropriate medicine to all the 224 active patients in order to prevent spread of the menace.”

Out of these 224 cases, 96 are multibacillary (MB) and 128 are paucibacillary (PB) cases. The MB category is contagious and more dangerous. Unfortunately, the family members of the MB patients are likely to suffer from the affliction at a later stage. Hence the need to take extreme precaution, Dr. Chahande stated.

“This disease is not a notified one due to which reporting by private doctors is not mandatory. Knowing this, we are engaged in aggressive campaigning and that is helping in bringing the cases to the fore,” said Dr S W Manekar, Senior Medical Officer of Leprosy Unit.

How are the cases identified? 

To this question, Dr Chahande replied, “The staff is trained to identify the cases. There are three points including hypopigmental patch, the anaesthesia (whether the patch has sensation or not; if there is no sensation at the patch, then it is an unfortunate case of leprosy), and hair loss. After the initial identification the suspected cases are sent to Urban Leprosy Centre (ULC) run by Nagpur Municipal Corporation. There are 26 ULCs. At the ULC, further examination is done to assess whether there is nerve involvement in the patient. We got 204 cases in rural and 20 cases in urban areas respectively.”

Is eradication of leprosy possible?

According to Dr Chahande, it seems a difficult challenge, thanks to many reasons. One, the incubation period of the disease is 5-6 years during which the patient does not have any pain or any other symptoms. So they approach doctors only when the symptoms are visible. Unfortunately, that is too late in the day. At such a late stage, combating the disease effectively becomes a very major challenge.

The authorities have noticed a good sign that the the number of leprosy patients is not rising. Yet, that may not be much of a solace since no sign of reduction in the numbers is visible, Dr Chahande added.

There are other issues as well in Nagpur District. The Government has sanctioned as many as 26 posts in various categories for the leprosy eradication campaign (based on the critarion of population of 25 lakh). However, only 14 posts have been filled. This number is inadequate and the manpower finds itself severely strained, ‘The Hitavada’ has learned, ‘The Hitavada’ has learned.

 “Of course, we do not sit idle after identifying the cases. We have already started an awareness campaign to awaken people dangerous possibilities. We also do an aggressive follow-up of the active cases. A medicine pack for 28 days is given to the afflicted persons. Our staffers visit the homes and pursue the drug consumption by the patients. The big solace is that Prevalance Rate (cases per 10,000 population) is decreasing. In 2011 it was 1.06 which has come down to 0.77,” Dr Chahande said.

It may be noted that the Government started a Leprosy Elimination Drive that ended on September 20, 2017. More than six crore people across Maharashtra were covered by the nation-wide door-to-door detection survey.
Dr Bhojraj Madke, Dr Anupama Rewale, Dr Hemlata Verma, Dr Shivajirao Phale, Dr R K Dodke are working hard to make the campaign a big success.

Years Active cases PR new cases
2011-12 496 1.06 765
2012-13 556 1.18 912
2013-14 515 1.06 745
2014-15 616 1.25 900
2015-16 461 0.92 784
2016-17 430 0.86 699
Till Aug 17 453 0.77 699

Leprosy and its effects

-Leprosy is a disease caused by a bacterium called Mycobacterium leprae that affects the nerves, upper respiratory tract and eyes

-It is an air-borne disease transmitted via droplets from nose and mouth

-Once a person is infected, the disease can take up to seven years to manifest

-If left untreated, the disease could lead to deformities
- The people who are less immune likely to suffer from this disease.
- No mortality of this disease ever reported but it gets diagnosed a bit late.