[The campaign against leprosy in an urban African environment: problems encountered at the level of case-finding and of monitoring of patients in Dakar].

The authors first explain the main epidemiological parameters of leprosy in Dakar, their evolution and their differences with those of the rest of the country. The second part deals with case finding and reveals the essential importance of the voluntary detection which appears as rather early: 3.5% of second degree physical disabilities; 37% of monomacular lesions in the paucibacillary lesions. The third part explains the problems encountered on leprosy control with the study of a cohort of 241 patients: 64% were missing in 4 years and half of them during the first year. At the end of 4 to 6 years, only 19% of the patients had a regular attendance at treatment. The defects are significantly more frequent with the male patients, and with the people who have been residing in Dakar for less than two years. In the suggested solutions, the authors insist on the necessity to adopt short multidrug protocols and to make health education for patients so that they care about case finding with their contacts.