Current situation of leprosy in India and its future implications

Abstract

The global leprosy situation has changed significantly over the last four decades after the introduction of multidrug therapy (MDT) in 1982 with a reduction in prevalence from over 5 million cases in the mid-1980s to less than 200,000 at the end of 2016. The programme in India also saw a reduction from a prevalence rate of 57.8/10,000 in 1983 to less than 1/10,000 by the end of 2005 when India declared to have reached the World Health Organization (WHO) target of elimination as a public health problem. Post 2005, major changes in the programme were made by the National leprosy eradication programme (NLEP) and the global leprosy programme, which may have affected the new case detection (NCD), disability, and child leprosy trends, which continue to show no appreciable regression. This article reviews the current global and Indian leprosy scenario to bring out its achievements and successes, including the impact of Leprosy Case Detection Campaigns (LCDC) on leprosy numbers. The basis and expected benefits of recent introduction of chemo and immune-prophylaxis in the programme are also discussed. It also discusses the shortcomings, the areas of concern, and the need for an inclusive strategy in the Indian leprosy programme that includes an intersectoral collaboration within the country for reaching the desired goal of leprosy eradication.

16S rDNA based skin microbiome data of healthy individuals and leprosy patients from India

“…Given this context, we endeavored to study the structure of skin microbiome in healthy controls as well as of leprosy patients from India, a country that accounts for the highest annual number of leprosy cases diagnosed/reported worldwide. In 2016, 34,000 new cases were reported alone from endemic states in India with 25% annual cases 36 . Given high variability with respect to dietary habits, climatic and life-style conditions within India, we chose two well-separated geographical locations within India (viz.…”

Incidence and Clinical Profile of Leprosy in a Tertiary Care Hospital in Hyderabad, Telangana

“…India accounts for 60% of new cases reported worldwide and are among the 22 "global priority countries" contributing 95% of the world numbers of leprosy necessitating a continued effort to bring down the incidence cases. 15 Henceforth, we conducted a retrospective study by reviewing medical records in our hospital setting to determine the incidence and clinical profile of newly diagnosed leprosy cases.…”

Patients help other patients: Qualitative study on a longstanding community cooperative to tackle leprosy in India

“…The studies were conducted in Raxaul, Bihar, which is a district located in India near the border of Nepal. India is still one of the 22 'global priority countries' which accounts for 95% of the global burden of leprosy [5,15] and Bihar is one of the poorest districts in India, where one fifth of the whole leprosy patients of India have been forming an endemic colony [16]. Thus, this area is characterized by leprosy patients begging for a living, and by communities that lack basic services such as education, medical treatment and sanitation.…”

“…funding and reallocation of resources for leprosy programs in India [5]. Due to limited resources, leprosy specialized services in India had to be integrated with the general healthcare system, which diverted attention away from leprosy [4].…”

“…Thereafter, it has been difficult for the government to sustain leprosy control activities. India still accounts for nearly 60% of all the world's incidence in leprosy and it seems that numbers are not going to decline anytime soon due to reduced government support [5].…”