Groenen G
Damien Foundation, PO Box 343, Vientiane, Laos.
Lepr Rev. 2002 Mar;73(1):29-40.
From 1979 to 1999, the ALERT leprosy control programme has covered a well-defined area in central Ethiopia using standardized case finding strategies. During this period, the leprosy prevalence has decreased more than 30-fold, there has been a 3-fold decrease in case detection and a 6-fold decrease in the case detection rate. The proportion of MB patients among new cases increased by around 80% and the proportion of children among new cases decreased by around 60%. Several factors may have contributed to these trends. The impact of the introduction of MDT and the shortening of the duration of the MB regimen are shown, but other factors are also discussed at length: an increase in the population of the area, cleaning up of the registers, changing case definitions, changes in staff motivation and fluctuations, even small ones, in case finding intensity and coverage. Do the observed trends reflect a reduction in the transmission of the leprosy infection? Because of the many confounding factors, it would be difficult to answer that question positively at present. Additional rigorous data collection and analysis is required.
1979年至1999年期间，“警报”麻风病控制项目运用标准化病例发现策略，覆盖了埃塞俄比亚中部一个明确界定的区域。在此期间，麻风病患病率下降了30多倍，病例发现数下降了3倍，病例发现率下降了6倍。新病例中多菌型患者的比例增加了约80%，新病例中儿童的比例下降了约60%。有几个因素可能促成了这些趋势。文中展示了引入多药联合化疗以及缩短多菌型治疗方案疗程的影响，但也详细讨论了其他因素：该地区人口增加、清理登记册、病例定义的变化、工作人员积极性的变化以及病例发现强度和覆盖率的波动（即使是小波动）。观察到的这些趋势是否反映了麻风病感染传播的减少？由于存在许多混杂因素，目前很难肯定地回答这个问题。需要进行更多严格的数据收集和分析。
