Leprosy
mailing list – September 20th, 2005
Ccn: all.
From: C R Revankar, New Jersey,
USA.
Dear Dr Bobin,
Your comment on significant reduction
in new case detection in India is well taken (P Bobin, LML
Sep. 12th, 2005).
It is mainly because of strictly following leprosy case
definitions (new case, previously treated case, treatment completion
etc) by the concerned health care workers.
NLEP India with the assistance of WHO/ILEP,
conducted systematic case validation exercise and LEM in 2003 and
2004. These simple exercises revealed over reporting of cases (over
diagnosis, recycling of cases or re-registration of cases, over
treatment etc). There
are several reasons for this over-reporting.
Such exercises have assisted the
programme to initiate corrective measures. As a result, case detection
rate is showing a declining trend.
Once we achieve a certain level of new
case detection (in reality) say after 20-25 years, one may not
notice a further decline or achieve "No new case level"
only with current practices.
Of course, we have to look at the other side of the coin:
under diagnosis and under reporting and programme coverage. We still
do not have a simple, inexpensive and reliable method of assessing these
aspects.
Regards,
CR Revankar
Dr. C R
Revankar MD, DPH
Consultant (Leprosy/TB/HIV/AIDS)
New Jersey
Email: revankarcr@gmail.com drrevankar50@vsnl.com
