Shukla Lipy K, Patel Rashendu N, Patel Sangita V, Baxi Rajendra K
Department of Preventive and Social Medicine, Medical College Baroda, Vadodara, Gujarat, India.
Indian J Dermatol Venereol Leprol. 2015 May-Jun;81(3):257-62. doi: 10.4103/0378-6323.154793.
Leprosy is probably the oldest disease afflicting mankind and a public health problem for centuries. Many cases are hidden or undiagnosed, especially due to social stigma, and neglect of painless patches. Between years 2001 and 2005, during which time active surveillance for detection of leprosy was in practice, a steep fall in the prevalence rate (PR) of leprosy was observed. However, during later years, leprosy program discontinued active surveillance for detection of leprosy cases. Presently block level awareness campaign (BLAC) is a special measure undertaken in a campaign mode during September-November in priority areas, (PR>1/10000 population), during which information, education and communication (IEC) activities and active surveillance of leprosy cases is done.
To evaluate the effect of Block Level Awareness Campaign on performance indicators of national leprosy elimination program (NLEP) in Vadodara district.
The campaign was carried out for 6 days in 12 talukas of Vadodara district by the district leprosy office, Vadodara. Trained teams of health workers carried out information, education and communication (IEC) activity and active surveillance by undertaking house to house survey in each primary health centre (PHC) area. Suspected cases were identified by the team and confirmed clinically by medical officers in the primary health centre of the corresponding areas. A district nucleus team (DNT) validated these confirmed cases. These data were compared with the district's national leprosy eradication programme (NLEP) data for the same year, 2012 and the previous year, 2011.
A total of 1,574,586 persons, comprising 76%of the population surveyed, were screened for leprosy, which resulted in detection of 358 clinically confirmed new cases of leprosy, out of which 225 (62.8%) were paucibacillary (PB) and 133 (37.2%) were multibacillary (MB) leprosy. Of these cases, 14 (4%) had deformities, and 37 (10.3%) were children.
Only 76% of the population could be covered. Histopathological confirmation of the diagnosis was not undertaken. Because of the large number of health workers invovled, variations in their skills may have influenced the diagnosis of suspected cases.
Active surveillance linked to focused block level campaigns can be useful tools to detect new hidden leprosy cases.
麻风病可能是困扰人类最古老的疾病,且数百年来一直是一个公共卫生问题。许多病例隐匿或未被诊断出来,尤其是由于社会污名以及对无痛斑块的忽视。在2001年至2005年期间,当时实施了麻风病主动监测,麻风病患病率(PR)出现了急剧下降。然而,在随后的几年里,麻风病防治项目停止了对麻风病病例的主动监测。目前,街区层面宣传活动(BLAC)是在9月至11月期间,在优先地区(患病率>1/10000人口)以活动形式开展的一项特殊措施,在此期间开展信息、教育和宣传(IEC)活动以及对麻风病病例的主动监测。
评估街区层面宣传活动对巴罗达地区国家麻风病消除项目(NLEP)绩效指标的影响。
巴罗达地区麻风病办公室在巴罗达地区的12个 talukas 开展了为期6天的活动。经过培训的卫生工作者团队通过在每个初级卫生保健中心(PHC)区域挨家挨户调查,开展信息、教育和宣传(IEC)活动以及主动监测。团队识别出疑似病例,并由相应区域初级卫生保健中心的医务人员进行临床确诊。一个地区核心团队(DNT)对这些确诊病例进行了核实。将这些数据与该地区2012年同一年以及2011年上一年的国家麻风病根除项目(NLEP)数据进行了比较。
总共筛查了1574586人,占被调查人口的76%,共检测出358例临床确诊的麻风病新病例,其中225例(62.8%)为少菌型(PB)麻风病患者,133例(37.2%)为多菌型(MB)麻风病患者。在这些病例中,14例(4%)有残疾,37例(10.3%)是儿童。
仅覆盖了76%的人口。未进行诊断的组织病理学确认。由于涉及大量卫生工作者,他们技能的差异可能影响了疑似病例的诊断。
与重点街区层面活动相关的主动监测可以成为发现新的隐匿麻风病病例的有用工具。