[Leprosy in Amazonas-impressions of the National Leprosy Program]. / Lepra in Amazonien ­ Eindrücke aus einem Kontrollprogramm.

Due to the often late detection and the neurological disability as a consequence of the disease, leprosy plays an important role in the public health system of emerging countries with the highest prevalence such as India and Brazil. The National Leprosy Control Program of the Ministry of Health and the Health Institutions of the Federal States in Brazil has implemented a strategy to ensure successful treatment of people in rural areas both at the preventive and curative level. A successful screening program, timely treatment of patients according to the stage of disease, and the introduction of preventive measures have significantly reduced the prevalence of leprosy in Brazil over the last 20 years. Due to limited medical care and socioeconomic weakness in the Amazon region in Brazil, the early eradication of leprosy does not seem to be currently realistic.

Brazilian Society of Dermatology against leprosy.

The Brazilian Society of Dermatology promoted a national campaign against leprosy in 2012, involving their State Regional, Accredited Services of Dermatology and Referral Services in Leprosy. Consisted of clarification to the population about the disease and a day of medical voluntary service. Ninety services (57 Accredited Services and 33 Reference Services) participated, distributed in 23 states. The campaign examined 3,223 people and 421 new cases were diagnosed, 54,4% female, 74,3% between 19 and 64 years and 8,3% in children under 15 years. Of the 217 classified cases, 58,5% was paucibacillary and 41,5% was multibacillary. The results were posted on the Brazilian Society of Dermatology website.

[Estimation of the execution of the national strategy of leprosy elimination in the "Hauts Bassins" region in Burkina Faso]. / Evaluation De La Mise En Oeuvre De La Strategie Nationale D'Elimination De La Lepre Dans La Region Des Hauts Bassins, Burkina Faso.

BACKGROUND: Burkina Faso achieved the leprosy elimination as a public health problem but this benefit was being lost. So, the National Program for Fighting against Leprosy has defined a strategy to reverse this situation. The aim of this survey was to evaluate the performance of the national program in the execution of this strategy in the region of "Hauts Bassins" (Burkina Faso) from 2005 to 2009. METHOD: The survey was led through the five sanitary districts of the region. It consisted in interview with the mean actors of leprosy control program and the analysis of the data notified on the leprosy cases, in order to estimate the progression of the key indicators of detection and follow-up care for patients having leprosy. RESULTS: During the survey period, 248 cases of leprosy were recorded including 236 new cases and 12 relapses. The prevalence of leprosy was 0.28 per 100 000 inhabitants in 2009. The detection rate decreased from 3.77 per 100 000 in 2005 to 2.75 per 100 000 in 2009. Among the 236 new cases of leprosy, 194 (82.2 %) were multibacillary form (MB). MB patients proportion increased from 69,3 % in 2005 to 91.1 % in 2009. The proportion of children was on average 3.8 %, the one of female cases 38.9 %. Newly diagnosed cases with grade 2 disabilities moved up from 21.4 % in 2005 to 42.2 % in 2009. The completion of cure rate was globally 88.26 %. The losts from follow-up among the patients who started multi-drug therapy were 7.14 %. CONCLUSION: The aim of the leprosy elimination as a public health problem is achieved but some challenges may be taken up, particularly in the organization of leprosy detection by the heath structures.

Improving physical health care in a mental health trust.

It is a challenge both to general medicine and psychiatry to develop systems that are better equipped to meet the physical health needs of mental health patients and reduce mortality rates (Hansen et al, 1997). Central and North West London Mental Health NHS Trust is establishing a department of physical health care staffed by nurses with general nursing backgrounds to tackle this problem. This nurse-led department is designed to train nurses and doctors in key aspects of physical health assessment and treatment interventions.

Impact of modified leprosy elimination campaign in a MDT pilot project district of India.

A study was carried out based upon the data available from National Leprosy Eradication Program of Purulia district in West Bengal. The result showed that the disease was in a declining trend up to the year 1998 and was inclining during the year 1998-1999 due to more case detection through MLEC-I, then followed by declining trend during the year 2000 as it was observed by MLEC-II. Single skin lesion rate was higher, MB rate was same and reduced deformity rate indicates early detection of cases due to better awareness of the community about the disease.

Leprosy elimination campaign, Amazonas-Brazil 1997.

A leprosy elimination campaign (LEC) was carried out in 15 endemic areas of Amazonas State, Brazil, in 1997. The LEC concentrated effort to detect leprosy cases during a multi-vaccination national campaign for serious public health problems other than leprosy, such as polio, diphtheria, hepatitis, measles, etc. The national campaign involved intensive population mobilization, giving a valuable opportunity to examine people for leprosy. The LEC personnel included 2964 individuals (municipal and state health workers and community volunteers), distributed in 688 health units and 53 reference health centres. As a result of the LEC, 74,814 person-to-person communications in the community were given; 10,297 clinical skin examinations were conducted, and 40 new leprosy cases were detected on the day of the campaign in urban areas of the municipalities. This total was low, compared to results in other states of Brazil, possibly due to the development of health education activities and regular community services in the state of Amazonas since 1987 and to the early implementation of WHO multiple drug therapy (MDT) from 1982 onwards. Despite the fact that the LEC was carried out only in the urban areas of the municipalities, the finding of no cases of leprosy in 7 out of 15 of them was surprising and may indicate that the prevalence of hidden cases of leprosy is not all that high, at least in these areas of the Amazonas State.