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DR. MOHD IRFAN (INTERN) NATIONAL LEPROSY ERADICATION PROGROM (NLEP)

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DR. MOHD IRFAN

(INTERN)

NATIONAL LEPROSY ERADICATION PROGROM (NLEP)

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WHAT IS LEPROSY? It is a chronic infectious

disease caused by M.leprae, an acid fast, rod shaped bacillus. It mainly affects the skin, peripheral nerves, and mucosa of the respiratory tract etc., It has left behind a terrifying image in history and human memory of mutilation, rejection and exclusion from society.

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• SPECIFIC LEARNING OBJECTIVES

Burden of leprosy in India Enlist 4 important Milestones in Leprosy Enumerate 5 components of National

Leprosy Eradication Program. Enlist initiatives under Disability

Prevention and Medical Rehabilitation.

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burden of leprosy The global registered prevalence of leprosy at the

beginning of 2006 was 219,826 cases. There are now only six countries that have still to reach the elimination target of 1 case per 10,000 population, at the national level.

Based on the reports received from all the states and UTs in India for the year of 2008-09 current leprosy situation in the country has been observed as below. A total of 1.34 lakh new cases were detected during

the year 2008-09, which gives Annual New Case Detection Rate (ANCDR) of 11.19 per 100,000 population. This shows ANCDR reduction of 4.36% from 11.70 during 2007-08.

A total of 0.86 lakh cases are on record as on 1st April 2009 giving a Prevalence rate (PR) of 0.72 leprosy cases per 10,000 population.

Detailed information on new leprosy cases detected during 2008-09 indicates the proportion of MB (48.4), Female (35.2), Child (10.1), Visible Deformity (2.8),

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• THE LEPROSY SCENARIO IN THE COUNTRY

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• MONTHLY PROGRESS REPORT FOR THE YEAR 2013-14

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MILESTONES OF LEPROSY ERADICATION

1948 – Hind Kusht Nivaran Sangh 1955 – National leprosy Control Program 1980 – Dapsone 1982 – MDT 1983 – National Leprosy Eradication Program( MDT

started) 1991 – World Health Assembly resolution to eradicate

leprosy by 2000AD. 1998-2004 – Modified Leprosy Elimination Program . 2005 Dec – Prevalence rate 0.95 /10,000 and

government declared achievement of elimination target. 2005 – NRHM covers NLEP . 2012 - Special action plan for 209 high endemic

districts 16 States/UTs

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COMPONENTS OF THE PROGRAM1.Decentralizing2.Capacity building3.Intensified IEC4.Prevention of DPMR5.Intensified monitoring

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NATIONAL LEPROSY ERADICATION PROGRAM

OBJECTIVES OF NLEP To achieve elimination of leprosy at national

level by the end of the project

To accomplish integration of leprosy services with general health services in the 27 low endemic states

To proceed with integration of services as rapidly as possible in the 8 high endemic states

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• Leprosy - one of the few diseases which can be eliminated

Leprosy meets the demanding criteria for elimination

practical and simple diagnostic tools: can be diagnosed on clinical signs alone;

the availability of an effective intervention to interrupt its transmission: multidrug therapy

a single significant reservoir of infection:

humans.

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•STRATEGIES IN NLEP 1. Early detection 2. Regular treatment 3.Public awareness campaigns 4.Medical rehabilitation

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Treatment

Rifampicin is given once a month. No toxic effects have been reported in the case of monthly administration. The urine may be coloured slightly reddish for a few hours after its intake, this should be explained to the patient while starting MDT.

Clofazimine is most active when administered daily. The drug is well tolerated and virtually non-toxic in the dosage used for MDT. The drug causes brownish black discoloration and dryness of skin. However, this disappears within few months after stopping treatment. This should be explained to patients starting MDT regimen for MB leprosy.

Dapsone :This drug is very safe in the dosage used in MDT and side effects are rare. The main side effect is allergic reaction, causing itchy skin rashes and exfoliative dermatitis. Patients known to be allergic to any of the sulpha drugs should not be given dapsone

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TREATMENT CONTD..

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DPMR ACTIVITIES- 3 TIER SYSTEM DPMR ACTIVITIES- 3 TIER SYSTEM

1.Primary level (First level ) 2.Secondary level (Second Level ) 3.Tertiary level ( Third Level ) Central government Institutes ICMR Institute JALMA , Agra .

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• ACHIEVEMENTS OF THE PROGRAM01 case per 10,000 population3 States are yet to achieve elimination.More focus is given to the districts and blocksUrban Leprosy Awareness Campaigns AID PROVIDED ARE

Dressing material , ulcer kits.Footwear.83 Reconstructive surgery centres (41+42).Incentives to BPL families.Support from the government.

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• THE "FINAL PUSH" STRATEGY FOR

THE "FINAL PUSH" STRATEGY FOR LEPROSY ELIMINATION Expand services Ensure new cases Encourage for treatment Promote awareness Set targets Stratify the problem Identify and target Promote campaigns Monitoring by WHO

THANKU