Leprosy
mailing list – September 12th, 2005
Ccn: all.
From: J Shen, Nanjing,
Jiangsu, People’s Democratic Republic of China.
Dear Dr Salvatore Noto,
Thank you very much for your
interesting email about clinical monitoring of people with
leprosy-related disability or those at risk of developing this and monitoring
of impairment status and POD from a public health point of view (W
v Brakel, LML Sept 10th, 2005).
In theory, there could be "two systems" of monitoring
disability. In fact, the monitoring of patients with leprosy -related
disability or those at risk of developing disability is the only way
to collect the basic data. It is that the data could be used for two
important purposes. One is monitoring the patients with leprosy
-related disability or those at risk of developing disability. The
other is to monitoring disability status based on large samples of the
patients.
I fully agree with you that we
should consider the problems in these two ways for making clinical
decision and evaluating the effectiveness of the programme conducted
by clinics or health facilities.
Thinking the problem is one thing, managing the problem is the other.
Your opinions are very important in POD among the leprosy patients. I
think it may be a weakness in some countries, especially those with a
high rate of leprosy reaction among the patients and in
difficult-to-reach area. In
these areas, I think the majority of the patients were in
deteriorating status other than improving in disability.
How to do if the health worker founds that the patient
was in deterioration of disability? What is the best way to
prevent the deteriorating process of disability? I think these are
important issues to be solved. Solving the issues should have the
cooperation of the various sections including patients, local health
facilities, NGOs and local governments in technique and funds
support.
Thank you again.
With kind regards,
Dr Shen Jianping
Dr Jianping SHEN,
Institute of Dermatology
Chinese Academy of Medical Sciences
National Centre for STD and Leprosy Control
Nanjing
Jiangsu
People’s Democratic Republic of China
