Lepra irfan

Lepra irfan

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  DR. MOHD IRFAN (INTERN) NATIONALLEPROSY ERADICATION PROGROM (NLEP)
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  WHAT IS LEPROSY? It is a chronic infectious disease caused by M.leprae, an acid fast, rod shaped bacillus. It mainly affects the skin, peripheral nerves, and mucosa of the respiratory tract etc., It has left behind a terrifying image in history and human memory of mutilation, rejection and exclusion from society.
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  • SPECIFIC LEARNINGOBJECTIVES  Burden of leprosy in India  Enlist 4 important Milestones in Leprosy  Enumerate 5 components of National Leprosy Eradication Program.  Enlist initiatives under Disability Prevention and Medical Rehabilitation.
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   burden ofleprosy  The global registered prevalence of leprosy at the beginning of 2006 was 219,826 cases.There are now only six countries that have still to reach the elimination target of 1 case per 10,000 population, at the national level.  Based on the reports received from all the states and UTs in India for the year of 2008-09 current leprosy situation in the country has been observed as below.  A total of 1.34 lakh new cases were detected during the year 2008- 09, which gives Annual New Case Detection Rate (ANCDR) of 11.19 per 100,000 population.This shows ANCDR reduction of 4.36% from 11.70 during 2007-08.  A total of 0.86 lakh cases are on record as on 1st April 2009 giving a Prevalence rate (PR) of 0.72 leprosy cases per 10,000 population.  Detailed information on new leprosy cases detected during 2008- 09 indicates the proportion of MB (48.4), Female (35.2), Child (10.1), Visible Deformity (2.8),
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  •THE LEPROSY SCENARIOIN THE COUNTRY
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  •MONTHLY PROGRESS REPORTFOR THE YEAR 2013-14
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   MILESTONES OFLEPROSY ERADICATION  1948 – Hind Kusht Nivaran Sangh  1955 – National leprosy Control Program  1980 – Dapsone  1982 – MDT  1983 – National Leprosy Eradication Program( MDT started)  1991 –World Health Assembly resolution to eradicate leprosy by 2000AD.  1998-2004 – Modified Leprosy Elimination Program .  2005 Dec – Prevalence rate 0.95 /10,000 and government declared  achievement of elimination target.  2005 – NRHM covers NLEP .  2012 - Special action plan for 209 high endemic districts 16 States/UTs
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  COMPONENTS OF THEPROGRAM 1.Decentralizing 2.Capacity building 3.Intensified IEC 4.Prevention of DPMR 5.Intensified monitoring
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  NATIONAL LEPROSY ERADICATIONPROGRAM  OBJECTIVES OF NLEP  To achieve elimination of leprosy at national level by the end of the project  To accomplish integration of leprosy services with general health services in the 27 low endemic states  To proceed with integration of services as rapidly as possible in the 8 high endemic states
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  •Leprosy - oneof the few diseases which can be eliminated  Leprosy meets the demanding criteria for elimination  practical and simple diagnostic tools: can be diagnosed on clinical signs alone;  the availability of an effective intervention to interrupt its transmission: multidrug therapy  a single significant reservoir of infection: humans.
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  •STRATEGIES IN NLEP 1. Early detection  2. Regular treatment  3.Public awareness campaigns  4.Medical rehabilitation
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  Treatment  Rifampicin isgiven once a month. No toxic effects have been reported in the case of monthly administration.The urine may be coloured slightly reddish for a few hours after its intake, this should be explained to the patient while starting MDT.  Clofazimine is most active when administered daily.The drug is well tolerated and virtually non-toxic in the dosage used for MDT. The drug causes brownish black discoloration and dryness of skin. However, this disappears within few months after stopping treatment.This should be explained to patients starting MDT regimen for MB leprosy.  Dapsone :This drug is very safe in the dosage used in MDT and side effects are rare.The main side effect is allergic reaction, causing itchy skin rashes and exfoliative dermatitis. Patients known to be allergic to any of the sulpha drugs should not be given dapsone
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  TREATMENT CONTD..
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  DPMR ACTIVITIES- 3TIER SYSTEM DPMR ACTIVITIES- 3 TIER SYSTEM  1.Primary level (First level )  2.Secondary level (Second Level )  3.Tertiary level (Third Level )  Central government Institutes  ICMR Institute JALMA , Agra .
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  •ACHIEVEMENTS OF THEPROGRAM 01 case per 10,000 population 3 States are yet to achieve elimination. More focus is given to the districts and blocks Urban Leprosy Awareness Campaigns AID PROVIDED ARE Dressing material , ulcer kits. Footwear. 83 Reconstructive surgery centres (41+42). Incentives to BPL families. Support from the government.
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  •THE "FINAL PUSH"STRATEGY FOR  THE "FINAL PUSH" STRATEGY FOR  LEPROSY ELIMINATION  Expand services  Ensure new cases  Encourage for treatment  Promote awareness  Set targets  Stratify the problem  Identify and target  Promote campaigns  Monitoring byWHO  THANKU