ABSTRACT
The changing demographics of India due to better life expectancy has led to significant increase in the geriatric population. Physiological changes due to aging lead to altered biological response to disease as well as coping with it. There are very few published studies that have addressed the issue of geriatric leprosy. This was a retrospective record review of 8-year data from a tertiary care centre in North India of leprosy patients aged 60 years or more. Clinical and demographic details were noted. Data was compared with 154 other leprosy patients aged 18-59 years. Out of 1083 leprosy cases, 80 (7.4%) were elderly and 67.5% of these were males. Majority (92.5%) were in the multibacillary (MB) spectrum. Type 2 reactions were more commonly seen than type 1 reactions in this age group. Pre-existing co-morbidities were present in 52.5% of patients. Grade 2 disability (G2D) was noted in 13.8% of cases, all of whom were in MB spectrum. Comorbidities were significantly higher amongst the elders whereas nerve involvement and G2D rates were higher amongst other leprosy patients (18-59 years). The prevalence of geriatric leprosy is on the rise due to better life expectancy. The high MB rate and G2D rate in geriatric population is a cause of concern for ongoing disease transmission and leprosy control programs. Due to a higher proportion of patients having pre-existing co-morbid conditions and polypharmacy, this sub-group needs special attention and care after release from treatment
ABSTRACT
The Elimination of Leprosy at National level was achieved in the month of December, 2005, by India. Afterward it was observed that trend of two important indicators of NLEP i.e. Annual New Case Detection Rate (ANCDR) and Prevalence Rate (PR) are almost static since 2005–2006, whereas the percentage of Grade II disability (G2D) amongst new cases detected showed a rising trend, which indicated delayed detection of cases and quantum of cases lying undetected/ hidden in the community. Hence, in order to address the issues being faced by programme an innovative approach for hidden case detection i.e., Leprosy Case Detection Campaign (LCDC) was introduced by Central Leprosy Division (CLD), Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare (MoHFW), Govt of India. This novel concept is first of its kind in the world as it has various unique features i.e., institutional framework at various administrative levels for planning, implementation and concurrent review of LCDC, formulation and training of search teams, Micro plan preparation, IEC activities, supervision and monitoring by identified supervisors and report submission. The activity was piloted in the limited areas of 50 districts of 7 states during March-April 2016 and in September, 2016 it was expanded to 163 districts of 20 States/ UTs to cover around 360 million population. During 2017, it was implemented in 255 districts of 23 States/ UTs to cover population of around 390 million. These efforts have yielded the desired result which is evident from the fact that approximately 67000 new leprosy cases were detected during the LCDCs in these 2 years (2016-17 & 2017-18) and number of G2D cases per million population also declined by more than 25%, from 4.48 cases per million in 2014-15 to 3.34 cases per million in 2017-18. In addition to the above, the benefits achieved through LCDCs are generation of large number of trained manpower who can suspect, identify leprosy cases and can carry out focussed IEC regarding leprosy.