Leprosy
mailing list – January 5th, 2005
Ccn:
all.
Ref.: over-diagnosis and under-diagnosis in leprosy
From:
C R Revankar
,
Mumbai
,
India
.
Dear All,
Happy New
Year!
I thank Dr.
Erik Post for circulating his frank views (lml 12
Dec. 2004) on the issues such as under-diagnosis, over-diagnosis
and registered /true prevalence rate in leprosy for further
discussion. These issues are not new. Quite often these points have
been discussed. Now these areas are surfacing and deserved to be
attended to. These issues are also discussed in other
chronic communicable diseases.
Geographic
coverage, population coverage, patient coverage, intervention coverage
etc are some of the important factors for the success of any
chronic communicable disease control. For several operational and
financial reasons, health service agencies (public/NGOs) are not able
to reach hard to reach geographic areas such as mountains, islands,
conflict areas, tribal groups and migrant population groups in urban
locations etc. Such left over/un-covered areas are to be tackled
during sub-national level leprosy elimination process.
Leprosy Case
Validation (LCV) practised by WHO/National Leprosy Programmes assesses
over-diagnosis in the field by using simple field methods which are
not expensive. But assessing under-diagnosis of leprosy
would be very taxing and expensive. We still do not have simple
and cheap field methods to answer this question.
Will Lot
Quality Assurance Sample (LQAS) or any other method assist to
answer this question?
Regards,
Dr. CR
Revankar.
Mumbai
drrevankar50@vsnl.com
