In order to achieve this, it is important to know the magnitude of the problem and the available resources. Estimates of the prevalence of leprosy are essential for planning and implementing an anti–leprosy program, and also to evaluate its results. Epidemiological surveys can be conducted to find cases of leprosy. Certain target populations could be surveyed e.g. slums, overcrowded dwellings etc. The aim of case detection is to identify and register all cases of leprosy as soon as possible after they’ve become evident. Surveys are usually carried out by primary health care workers (village health guides, multi–purpose workers) in case detection with the active participation of the community.
The case identification is based on the finding of skin patches which have no sensation. Leprosy, like all other communicable diseases is an important disease that merits attention if we have to achieve the object of ‘Health For All’.
The three main goals of leprosy control are
- To interrupt the transmission of infection, thereby reducing the incidence of the disease, so that it no longer constitutes a public health problem.
- To treat patients in order to achieve their cure and wherever possible, rehabilitate them.
- To prevent the development of associated deformities.
Rehabilitation is therefore an integral part of leprosy control. It must begin as soon as the disease is diagnosed. The cheapest and surest rehabilitation is to prevent physical deformities and social and vocational disruption by early diagnosis and adequate treatment.
The following preventive measures are important in the control of leprosy:
Health Education should be directed towards the patient and his family, and the general public. The patient and the family should be educated about the need for regular treatment, repeated examination of contacts, self care regarding the prevention of disabilities, and protection of children.
Generating an awareness among people that leprosy is curable, not all leprosy patients are infectious, regular and adequate treatment is essential to obtain cure and prevent disabilities, and that the patient needs sympathy and social support.
It should be impressed upon them that leprosy is not hereditary, casual contact with a patient does not cause leprosy. This can help remove some of the social stigmas associated with the disease. Health education aims at ensuring community participation in order to achieve these objectives.
There is a growing realization that technological advances alone cannot solve the leprosy problem, unless we succeed in involving the public in the control program. They should be made aware that leprosy is not a hereditary disease, it is a bacterial disease like tuberculosis and that it is curable.
Socio–economic considerations in the control of leprosy
Preventing contact with infectious cases is an accepted method of controlling the spread of any communicable disease. It is difficult to envisage effective leprosy control without a significant improvement in the socio–economic conditions of the affected communities. The economic and social problems of the patient and his family should be identified and met.
Leprosy control is a long term activity. Therefore, planning and program management are essential ingredients. An important aspect of leprosy control is to assess the impact of the control operations on the endemicity of the disease, and to compare results between different times and places. Indicators are required for such an evaluation. It is important that these indicators can be easily used.