Online edition of India's National Newspaper
Monday, Feb 04, 2008
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Online edition of India's National Newspaper Monday, Feb 04, 2008 ePaper | Mobile/PDA Version |
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Tamil Nadu
CHENNAI: Though the prevalence of leprosy has come down less than 0.53 cases per 10,000 of population in Tamil Nadu, and the country as a whole, the take-away message from the recent observance of the World Leprosy Day is not to relax guard. Health experts feel that the Tamil Nadu experience offers invaluable lessons to communities elsewhere where the disease flares up. “An intense, focussed and mass-based network was the only route to eradication, and Tamil Nadu achieved it exactly by pioneering a massive exercise in 1991,” said N. Murugesan, who was State Project Coordinator-Advisor for the Multi Drug Treatment Project funded by the Danish International Development Assistance (DANIDA). Currently, there are 4,000 patients under treatment in the State, and 40 per cent of them account for cases of infection capable of transmission. Though the active transmission chain was broken, new cases still emerged, and anyone with a skin lesion without sensation should consult a physician, Director of Public Health P. Padmanabhan said. Early diagnosis and treatment were key to preventing deformities. The other important message was for those diagnosed as infective to continue an uninterrupted treatment for 12 months, he said. One of the major issues of the National Leprosy Eradication Programme (NLEP) had been the huge time-gap—almost three years—before a leprosy worker would revisit a household for a repeat screening. Given the long incubation period of the bacilli, a large number of patients were missed out during the screening. So it was impossible to cut the transmission chain. Tamil Nadu was contributing to one-third of the total cases in the country, and along with Andhra Pradesh, it accounted for two-thirds of the cases. The key to eradication was in facilitating an aggregation of political and bureaucratic will, community mobilisation and involvement and health workers’ motivation. Launched in the undivided South Arcot district before it was replicated all over Tamil Nadu in 1997, the strategy involved a mass-based screening that integrated leprosy services with the general healthcare system of the government and trained around 35,000 health functionaries and sensitised stake-holders. Even illiterate women were trained in detecting skin discoloration. The three-phased Danish Assistance to the NLEP, DANLEP, continued to support the MDT programme till 2003. A leaf or two from the intensive education-case detection-treatment drive went into the annals of the World Health Organisation, which included a few core elements of the campaign in its Modified Leprosy Eradication Campaign, and implemented it all over the country, said Dr. Murugesan, now the director, India Diabetes Research Foundation.
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