Leprosy cases remain undetected in Karnataka

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National Leprosy Eradication Programme (NLEP) data show a decrease in the number of reported leprosy cases, but that may not be the real story.

Bangalore, February 1, 2018: The number of leprosy cases across the state may have gone down, if one goes by the NLEP data. Yet, this fall doesn’t show the actual scenario as many leprosy stricken people remain undetected.

The NLEP data shows that the number of the cases reported in Karnataka has come down from 3071 in 2010-11 to 2313 in December 2017. However, several experts believe that these numbers are not reflective of the ground reality.

Doctor B.N. Rajani, Joint Director of Leprosy in charge said, “The interstate migration and spreading urbanization, especially in the case of construction workers is creating a hurdle in tracking leprosy cases because when these cases are reported the level of deformity is much higher.”

Leprosy paramedical worker, Mr. Masthan Shaheb from Sumanahalli Leprosy Rehabilitation Training Centre said, “At present, there is no door to door survey by medical officers and because of this situation only those people who are coming out voluntarily are being reported. A lot of people in their early stage of leprosy do not report thinking that it some kind of sins or cures.”

A.K Puri, Assistance Deputy Director from NLEP said that it is difficult to say that the numbers are accurate because such national programs have their operational limitations. A lot of these cases are not being reported because we do not conduct door to door survey in all the areas. Door to door surveys are only conducted in high endemic areas under Leprosy Case Detection Campaign. Focus Leprosy Campaign is only conducted in areas where leprosy leads to deformity.

“Eradication of leprosy was a vertical program where the focus was only on leprosy and the leprosy department had a separate staff to conduct surveys but now it has been integrated and includes programs for other diseases,” Dr. Rajani said. She

believes that prioritization of the leprosy eradication program is needed.

“There are a lot of misconceptions attached to this disease and because of that people are not coming and reporting it in the early stage. So, this decreasing trend does not show the real picture,” said Mr. Shaheb.

“If a case has not been reported in its early stage, it can become more severe because destruction of nerve endings will continue,” said Dr. Ayub Ali Khan Zai, administration medical officer at Leprosy Hospital, Bangalore.

Mr. Puri said that out of 644 districts in India, Leprosy programs are only conducted in 196 districts. Out of these 196 districts, if a person is found infected in a particular village then the whole village undergoes scanning, and if a person is identified in an urban area then the 300 surrounding households undergo scan. On top of everything, the misconception and incubation period also results in under reporting of these cases.

A member of the Society for Community Health Research and Awareness (SOCHARA) said that these data are under reported and due to the decreasing prevalence rate, at present there is lack of good quality surveillance. These programs are poorly funded. We should also consider the aspect that many of these cases are being reported at various private hospitals, he said.

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