Leprosy
Mailing List, March 17th,
2009
Ref.:
Terminology
From:
Frankel R. I., Honolulu,
Hawaii,
USA
Dear
Dr. Noto,
The
WHO choice of a prevalence of less than 1 leprosy case per 10,000
population as a target was described not as elimination of the disease
but elimination of the disease as a public health problem.
While one can argue with the choice of that specific prevalence rate,
I believe that this is a valid epidemiologic concept. I also
belive, however, that it should only be used by those who are
knowledgeable about leprosy and the epidemiology of this disease.
As
pointed out by Ms. Poorman (LML 2 March 2009), reaching the WHO target
goal does not mean elimination of the disease for those who have
chronic impairment. Likewise those who are newly diagnosed with
leprosy do not have any reason to think that the disease has been
eliminated. I think one can discuss 'control' of leprosy with
any audience but that the use of the term 'elimination' should be
restricted as I indicated above.
I
applaud Ms. Poorman for raising this issue. Aside from her
making an astute observation, I think it takes courage for a medical
student to express her or his opinion to a group of people with years
of knowledge and experience in the field. Anyone can certainly
disagree with her, but I think it is inappropriate to assail her for
expressing her concern.
Sincerely,
Richard
I. Frankel, M.D., M.P.H., F.A.C.P.
Emeritus
Professor of Medicine
University
of
Hawai'i
