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With the reduction on caseload due to the impact of multidrug therapy (MDT) in most parts of India, we believe that there is a need to understand the epidemiology of disabilities in leprosy which may not necessarily correlate with the distribution pattern of active disease. We present a methodol ogy of data collection and verification taking the district as a unit to calculate the prevalence rate of disability as an exclusive entity in the district population, unrelated to the problems posed by the communicable component of leprosy. This study indicated that the prevalence rate of Grade II disabilities in 14 hyperendemic districts was 0,82/1000, whereas it was 0'22/ 1000 in low endemic districts. Limb disability data collected from three hyperendemic districts in Andhra Pradesh following task-oriented training enabled the paramedical worker to offer services to 5753 disabled patients after assessing the disability caseload per worker.

Summary To study the feasibility of integrating leprosy treatment into the general health services in Bombay, 198 doctors ( essentially private medical practitioners), 120 interns, 32 nurses and 126 other auxiliary health staff were involved in intensive orientation programmes of various types, and doct ors were offered a free consultative service and guidance , with a free supply of dapsone. They were encouraged to treat leprosy patients in their own set-up without referring them elsewhere.After 18 months' follow-up, it was found that 108 doctors (59%) suspected 77 1 leprosy cases, of which 724 (94%) were labelled as leprosy. The investigators confirmed personally 129 of 158 (82%) which were seen by these doctors: 70% were of tuberculoid ty pe, 6% were lepromatous and 22% borderline type. Out of 50 whose skin smears could be taken 25 (50%) were positive for AFB. At thc end of scheme, it was found that 42% of all cases were under regular treatment.

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