World Leprosy Day (63rd) : 'To live is to help to live'

World Leprosy Day takes place on the last Sunday in January, The day aims to raise awareness of a disease that many people believe to be extinct. It was chosen by French humanitarian Raoul Follereau in 1953. Leprosy is an infectious disease of the skin and nerves which, if not diagnosed and treated quickly, can result in debilitating disabilities. The effects of leprosy are exacerbated by the negative stigma surrounding the disease.





The theme of World Leprosy Day 2016 is'To live is to help to live'.It is a 63rd World Leprosy Day. Leprosy is one of the Neglected tropical diseases.
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes, apart from some other structures. Leprosy has afflicted humanity since time immemorial. It once affected every continent and it has left behind a terrifying image in history and human memory - of mutilation, rejection and exclusion from society.

Situation of Leprosy in Nepal
During the FY 2070/71 a total number of 3,223 new leprosy cases were detected and were put under MDT and 2,271 cases were under treatment at the end of the fiscal year. At the end of FY 2070/71 there were 2,271 leprosy cases receiving MDT in the country, which makes the registered prevalence rate of 0.83/10,000 populations at national level. This rate is well below the cut‐off point of <1 /10,000 population. 109 cases of visible disability (G2D) were recorded in the fiscal year 2070/71.
(Annual Report 2071/71 DOHS)
Evolution and milestones of leprosy control program in Nepal
Gorkhapatra Daily (1/31/2016)
  • 1960 ‐Leprosy survey by Government of Nepal (GoN) in collaboration with World Health Organization (WHO).
  • 1966 ‐Pilot project to control leprosy launched with Dapsone monotherapy.
  • 1982 ‐Introduction of Multi Drug Therapy (MDT) in leprosy control program.
  • 1987 ‐Integration of vertically shaped leprosy control program into general basic health services.
  • 1991 ‐National leprosy elimination goal was set.
  • 1995 ‐Focal persons (TB and Leprosy Assistants‐TLAs) for districts & regions appointed.
  • 1996 ‐All 75 districts were brought on MDT
  • 1999/2000‐
  • 2001/02
  • Two rounds of National Leprosy Elimination Campaign (NLEC) were implemented.
  • 2008 ‐Intensive efforts made for achieving elimination at national level
  • 2009 ‐Leprosy elimination achieved at national level
  • 2010 ‐Elimination at national level declared
  • 2011 ‐National strategy was introduced
  •        - National guidelines was revised
  • 2012‐2013 ‐Elimination sustained at national level
  • 2013‐2014 ‐Mid Term Evaluation on Strategy 2011‐2015



Disease Control: LEPROSY
Targets
  • Reduce New Case Detection Rate (NCDR) by 25 % at national level by the end of 2015 in comparison to 2010
  • Reduce Prevalence Rate (PR) by 35 % at national level by the end of 2015 in comparison to 2010
  • Reduce by 35% Grade 2 disability (G2D) amongst newly detected cases per 100,000 population by the end of 2015 in comparison to 2010
  1.  Additional deformity during treatment <5% by eyes, hands and feet (EHF)         score
  2.  80% health workers are able to recognize and manage /refer                   reaction/complications
  3. Promote prevention of disability in leprosy(POD) and Self care
These targets will be revised after midterm evaluation.

Globally WHO has guided to reduce the burden due to Leprosy and Bangkok declaration has committed to reduce the G2D below 1/1 million and to increase the resources for leprosy, early diagnosis awareness to reduce stigma and rehabilitation in partnership approach. 
Goal
Reduce further the burden of leprosy and to break channel of transmission of leprosy from person to
persons by providing quality service to all affected community.
Objectives
  1. To eliminate leprosy (Prevalence Rate below 1 per 10,000 population) and further reduce disease burden at district level.
  2. To reduce disability due to leprosy.
  3. To reduce stigma in the community against leprosy.
  4. To provide high quality service for all persons affected by leprosy.5. To integrate leprosy in the integrated health care delivery set‐up for provision of quality services. 
    Kantipur (2/1/2016)
Strategies
The new national strategy has envisioned delivering quality leprosy services through seventeen strategic
areas including greater participation and meaningful involvement of people affected by leprosy and
right based approaches in leprosy services broadly they are categorized into 10 which are as follows:
  1. Early new case detection and their timely and complete management
  2. Quality leprosy services in an integrated setup by qualified health workers
  3. Prevention of leprosy associated impairment and disability
  4. Rehabilitation of people affected by leprosy, including medical and community based rehabilitation
  5. Reduce stigma and discrimination through advocacy, social mobilization and IEC activities and address gender equality and social inclusion.
  6. Strengthen referral centers for complications management
  7. Meaningful involvement of people affected by leprosy in leprosy services, and address human right issues
  8. Promote and conduct operational researches/studies
  9. Monitoring, supportive supervision including onsite coaching, surveillance and evaluation to ensure/strengthen quality leprosy services
  10. Strengthen partnership, co‐operation and coordination with local government, external development partners, civil society and community based organizations.
Source: DoHS, Annual Report 2070/71 (2013/2014)
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