Leprosy mailing list – July
5th, 2005
Ccn:
all.
Ref.: an
indicator that directly and accurately measures the level of leprosy
transmission?
From: O Ogbeiwi, Garki,
Abuja
,
Nigeria
.
Dear Dr
S Noto
,
From your
response (LML June 16th,
2005), it seems we both agree that true elimination refers to
a situation of zero-incidence of leprosy and not registered
prevalence of less than one case per 10,000.
However,
as it is with most leprosy control programmes presently, leprosy
incidence is difficult to estimate or even to measure accurately
because of the dependence of leprosy case detection on
operational and social/community factors in the programme,
specifically, the level of activeness of programme operatives in case
finding and social stigma and ignorance of leprosy. These make
also the use of case detection as an indicator of elimination less
accurate than desired, as there may be ongoing but undetected leprosy
transmission in countries or communities that reported zero-case
detection. Therefore zero-case detection is not equal to
zero-incidence of leprosy.
Using
registered prevalence is unacceptable because of many reasons already
exposed, but where do we go from here? Wanted: an indicator that
directly and accurately measures the level of leprosy transmission at
the population level!
Dr
Osahon Ogbeiwi
, TLM-AMES
