Leprosy among inmates of a prison.

A leprosy survey carried out in a district prison revealed a gross prevalence of 20 cases per 1000, and active prevalence of 10 cases per 1000 whereas, prevalence of leprosy in the state was 1.12 per 1000. Such prisons thus form hyperendemic pockets. The inmates are a closed community and there is a risk of cases among inmates spreading infection to others inside the prison during their sojourn there and to the community when they are released from the prison. Special efforts are required to identify and eliminate all identifiable sources of infection, especially at this point of time when we are aiming at elimination of leprosy as a public health problem.

Incidence of "chance" smear positivity among MB leprosy patients after MDT.

Multidrug therapy (MDT) was introduced in 1982. Nine hundred eighty multibacillary (MB) leprosy patients had successfully completed the MDT administered for a minimum of two years or till skin smear negativity, whichever was later, as recommended by the World Health Organisation (WHO). During surveillance, 2.24% of them revealed presence of acid-fast bacilli (AFB) in the skin smear. They did not have any clinical evidence suggestive of relapse. Subsequent followup (without antileprosy chemotherapy) for periods ranging from one to eight years was uneventful. We have called this as "chance smear positivity" where a few bacilli, yet to be cleared by the immune system, were picked up by routine skin smear examination.