RESUMEN
The leprosy elimination at national level was achieved in India in December 2005, however, Chhattisgarh is the only State yet to achieve same at State level and reported highest ANCDR/100000 population, i.e., 29.7 as on 31st March 2020. The efforts of the National Leprosy Eradication Programme (NLEP) are admirable wherein several initiatives introduced in phased manner since 2015, but there is need to understand the local scenario for effective control of this chronic disease in Chhattisgarh. This study conducted to identify various socio- demographic, behavioural, environmental factors associated with leprosy occurrence in high endemic district named Raipur. A community-based case control study design was adopted with inclusion criteria for cases as diagnosed, confirmed, and classified leprosy patients as per the WHO recommendation and NLEP Guidelines and controls as matched with cases' sex, age, (excluding the family members) and inhabiting same local area. Total 448 cases and 439 controls were interviewed from the district, after stratification of blocks based on G2D percentage among new cases detected & distribution of the sample (meant to be drawn from district) in proportion to the new cases reported by each stratum during year 2019. Data regarding socio-demographic profile, personal practices, disease profile & case history was collected through 2 different predesigned schedules. Descriptive, stratified analysis was performed along with chi square test score calculation for each variable. Further, bivariate & multinomial logistic regression was done to calculate adjusted odds ratio (for religion, age, caste, gender, education, occupation, residential area, family income) as measure of association. Low education level, absence of windows and safe water supply in household, use of same towel by multiple family members and history of contact with leprosy patients in family/ friends were found to be significantly associated with leprosy occurrence. The interventions targeted against these factors, i.e., emancipation of education level, IEC for hygiene, ventilation etc. may help in curbing the leprosy transmission in this high endemic district and other districts facing the same menace.
RESUMEN
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.