Programmes

Leprosy Elimination

Introduction

Leprosy is a chronic infectious disease caused by M. Leprae, an acid-fast, rod shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes, apart from some other structures.

Leprosy has afflicted humanity since time immemorial. It once affected every continent and it has left behind a terrifying history and human memory of mutilation, rejection and exclusion from society.

National Leprosy Control Programme (NLCP) in Gujarat was started from 1955. With the advent of MDT (Multi Drug Treatment) this national programme was re-designated as National Leprosy Eradication Programme (NLEP) in the year 1983.

In 1983 MDT was introduced in phase manner and the whole Gujarat state was covered by MDT in the year 1991. The goal of NLEP was to reduce the prevalence rate to less than 1 per 10,000 populations by 2005.

The goal of leprosy elimination is achieved in Oct-04 by having PR 0.95 at State level. Multi Drug Treatment available in all Government Hospitals free of cost.

Prevalence Rate of State is 0.61/10000 population in October 2018. Aims of state are to achieve elimination of leprosy at district & sub district level.

Out of total 33 districts, 24 districts achieved elimination stage but 09 districts of Surat and Vadodara zone having PR > 1. These districts are Dahod, Panchmahal, Narmada, Bharuch, Tapi, Navsari, Dangs, Valsad, Chhota Udepur.

Goal

Goal of NLEP is to eliminate leprosy from the state, where elimination means to reduce the proportion of leprosy cases to very low levels specifically below the level of one case/10000 population, through the effective application of technology i.e. MDT), so that it will not remain as public health problem.

Global Goal:

Reducing the rate of new cases with Grade-II disabilities per 100000 populations at least 35% in next five years and provide qualitative disabilities services and reconstructive surgery to leprosy affected persons.

Objectives:

Elimination of Leprosy at district level, i.e.PR<1/10,000 population in district level by March.2018.

To reduce less than one/Zero grade II disability by March 2018.

  • To review the current trends of grade-2 disabilities among new cases
  • Early Case Detection by routine and special drive every year.
  • Routine and camp base Reconstructive Surgery.
  • Distribution of Micro Cellular Rubber shoes, Ulcer Kit & Aids appliances (Splint)
  • Post exposure chemoprophylaxis with single dose of rifampicine

To achieve NLEP National Goal the following activities are carried out in the state

New Case Detection:

All undetected cases should be detected & treated with MDT. So that the quantum of infection will reduce and this will help in breaking the chain of transmission. Special activity plan is one of the important components for the same.

Quality MDT, Disability Prevention and Medical Rehabilitation (DPMR) Services :

MDT Services which include diagnosis and treatment completion while Disability prevention and Medical Rehabilitation includes disability care and care for complications of leprosy. It should be available in every Health Institution and at patient’s doorsteps through General Health Care System. Patients of Leprosy should be cured without disabilities and those who have already developed disabilities should get Quality Disability Care.

Nerve Function Assessment :

To prevent disability Nerve Function Assessment is carried out and all nerve damaged and muscle weakness patients are treated with prednisolone and this activity is continuous ongoing activity under Disability Care Programme.

Treatment Compliance:

We ensure achieving high level of treatment compliance & treatment completion. State Treatment Completion Rate is 98.9% (2013-14) which is higher than national level.

Awareness :

We are improving awareness about the disease & free availability of MDT services at Government Health Facilities, so that persons affected with leprosy availed MDT before the development of disabilities. Organized Information Education and Communication (IEC) is ongoing in all districts to facilitate self reporting and new case detection.

Special Activity Plan & Leprosy Case Detection Campaign (SAP-LCDC):

Campaign Activity - To detect hidden cases by team of ASHA & male local volunteer in every village of 12 high endemic districts, SAP-LCDC is carried out.

Special Activity Plan

Following activities are carried out in Special Activity Plan:

  • House to House visit by search team of ASHA, General Health Care Staff for suspecting case
  • Confirmation of Suspects by team of MO PHC and District Nucleus Team (DLO, DNMO).
  • Intensive IEC activity prior to house visit
Year New Case Detected
2012-13 2704
2013-14 3372
2014-15 3035
2015-16 4850

Sparsh Leprosy Awareness Campaign

30th January as Anti Leprosy Day every year, wherein nationwide message on leprosy awareness is spread through print and other media. In addition the IEC activities for leprosy elimination run for a fortnight. From now onward this day is envisaged to be celebrated as ‘Sparsh Leprosy Awareness Campaign’ wherein nationwide Gram Sabhas organized in cooperation and coordination with allied sectors of health department/ministries i.e. Panchayati Raj Institutions, Rural Development, Urban Development, Women and Child Development and Social Justice and Empowerment etc.

Year New Case Detected
2016 -17 4567
2017-18 4257

Leprosy Case Detection Campaign (LCDC) -

To detect hidden cases by team of ASHA & male local volunteer in every village of 11 high endemic districts, LCDC is carried out

Year New Case Detected
2016 -17 3539
2017-18 3084
2018-19 1219

Special Survey in Hard to Reach Areas 2017-18:

A special survey was planned in Hard to Reach Areas as a part of intensive case detection activities. Total 14 new leprosy cases were detected during 18/1/2018.

Disability Prevention and Medical Rehabilitation (DPMR): DPMR Services:

  • Reactions Management: During 2016-17, 508and current year 2017-18(up to March-18) ,460 reaction cases managed at PHC and District Hospital.
  • Ulcer Care: During 2016-17, 2034and current year 2017-18(up to March-18) ,2835 ulcer care kits are provided to needy leprosy affected persons.
  • MCR Footwear Distribution: During 2016-17,11951 and current year 2017-18(up to March-18) ,10802 MCR foot wear provided to needy leprosy affected persons.
  • Reconstructive Surgery:During 2016-17, 115and Current year 2017-18(up to March-18) ,92 Major reconstructive surgeryoperation are carried out to Gr.II needy leprosy affected persons.
  • Microcellular Rubber Shoes (MCR Shoes) Distribution:Special footwear supplied to leprosy patients who are having loss of sensation in sole or ulcer in foot to prevent them from further damage. During current year total 8741 MCR shoes provided to needy patients.
  • Reconstructive Surgery (RCS): Reconstructive Surgery have been done to correct the deformity of Leprosy Affected Person. During 2017-18, total 92 reconstructive surgeries have been done.
  • Ulcer Kit: Ulcer care kits are provided to needy leprosy affected persons having ulcer in foot. During 2017-18, total 2371 ulcer kit provided to needy pts.

Recognized Reconstructive Surgerycenters:

  • Civil Hospital, Asarva, Ahmedabad
  • SSG Hospital, Vadodara
  • New Civil Hospital, Majura Gate, Surat

Present NGOs working in NGO SET scheme:

Sr.No Name of Trust Address Contact No Email ID
1 ShramMandir Trust Sindhrot, Vadodara, District Vadodra, Gujarat 0265-6452660
0265-6451659
-
2 SahyogKusthYgna Trust Rajendranagar, Raigadh, Himatnagar-Shamlaji Highway, District : Sabarkantha, Gujarat 02772-254337
02772-254537
sahyogtrust@ymail.com
3 Gujarat RakpitNivaranSeva Sang Tarsali, DhaniyaviRaod, Ta: Dist: Vadodara, Gujarat 0265-2646361 sevatirth@yahoo.com
4 Swavlamban Trust Himavan, Paladi, Ahmedabad 079-26587623 -
5 Sulochana Memorial Health and Education Trust 31, Yogeshwar Nagar Society, Opp. DharnidharDerasar, Bhattha, Paladi, Ahmedabad 380007 079-65459933
079-25622207
-

New NGO Scheme:

New NGO scheme are implement as per GOI guideline from 1st April 2014. Details of schemes are as below:

  • Scheme 1A - Designated Referral Centres (DRC 1A) Out-patient facility
  • Scheme 1B - Designated Referral Centres (DRC 1B) Out-patient and In-patient
  • Scheme 1C - Designated Referral Centres (DRC 1C) Out-patient, In-patient and RCS
  • Scheme 2 - Comprehensive Care for Underserved Areas
  • Scheme 3 - Contact Survey and Home Based Self Care
  • Scheme 4 - Disability Care Centre - Leprosy Colonies
  • Scheme 5 - Advocacy Communication and Social Mobilisation with activities to reduce Stigma and Discrimination in Leprosy
  • Scheme 6 - Partnering with community for elimination of leprosy

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