Rao P Narasimha, Suneetha Sujai
Comprehensive Dermatology Clinic, Masab Tank, Hyderabad, Telangana, India.
Codewel-Nireekshana, Narayanaguda, Hyderabad, Telangana, India.
Indian Dermatol Online J. 2018 Mar-Apr;9(2):83-89. doi: 10.4103/idoj.IDOJ_282_17.
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.
自1982年引入多药联合化疗（MDT）以来，在过去四十年中，全球麻风病状况发生了显著变化，患病率从20世纪80年代中期的500多万例降至2016年底的不到20万例。印度的项目也出现了患病率下降，从1983年的57.8/万降至2005年底的不到1/万，当时印度宣布已实现世界卫生组织（WHO）将麻风病作为公共卫生问题消除的目标。2005年后，国家麻风病根除计划（NLEP）和全球麻风病计划对该项目进行了重大调整，这可能影响了新病例发现（NCD）、残疾情况和儿童麻风病趋势，这些趋势仍未出现明显的回落。本文回顾了当前全球和印度的麻风病情况，以展示其取得的成就和成功，包括麻风病病例发现运动（LCDC）对麻风病病例数量的影响。还讨论了该项目近期引入化学预防和免疫预防的依据和预期益处。文章还讨论了印度麻风病项目的不足之处、关注领域以及采取包容性战略的必要性，该战略包括在国内开展跨部门合作，以实现消除麻风病的预期目标。
