Leprosy
mailing list – April 5th, 2006
Ccn: all.
Ref.: Levels of
prevention of disabilities (POD)
From: Brandsma W., Pokhara, Nepal.
Dear Salvatore,
This is a short note in response to a
letter by D Soutar (LML March 22nd reply to Dr Ganapati). I would like to comment on the
following phrases in this letter: "…focus on earliest
possible POD…" and "…. those having grade 1
disability not progressing to grade 2 disability …". I suggest that we recognise
the following levels of POD:
Level 1.
Prevention of the Disease (also POD):
breaking the chain of transmission: Hygiene / BCG.
Level 2.
Early diagnosis and regular / adequate
treatment of the disease.
Level 3.
Early recognition and adequate
treatment of Nerve Function Impairment (primary impairments,
prevention of WHO Grade 1 and Grade 2 impairments (disability))
Level 4.
Prevention and treatment of impairments due to NFI (which
is prevention of secondary impairments e.g. ulcers and contractures).
Grade 1 and Grade 2 impairments, in
the context of WHO 'disability grading', refer usually to primary and
secondary impairments as a result of nerve function impairment. POD usually refers to level 4
activities.
In the context of the WHO
International Classification of Functioning, Disability and Health (ICF,
WHO 2002), the disease and its 'consequences' may lead to 'disability'
(umbrella term) which may be impairments, activity limitations and
participation restrictions.
Sincerely yours,
Wim Brandsma
wim@wimariet.com
www.wimariet.com
