Leprosy affected beggars as a hidden source for transmission of leprosy.

BACKGROUND & OBJECTIVES: Despite the large scale implementation of multidrug therapy (MDT), the incidence rates of leprosy have not declined in several hyperendemic countries. Before searching for non-human reservoirs of leprosy it would be necessary to look for hidden human sources. This would include destitute leprosy affected persons who resort to begging and operate in congested areas. Hence this study was undertaken. METHODS: One major town and three semi-urban areas in Vellore district of Tamil Nadu and Chittoor town in Andhra Pradesh were purposefully selected for the study. All beggars in these towns were systematically identified and examined by allopathic doctors. Skin smears were examined for bacteriological index. RESULTS: Among the 193 beggars screened, 58 had leprosy. Of these 10 were smear positive. Several beggars, although living separately, were in touch with their relatives. Most beggars were pavement dwellers and regularly begged at places of worship, bus stands and shopping centres. INTERPRETATION & CONCLUSION: The fact that nearly 20 per cent of the leprosy affected beggars were skin smear positive highlights the need for regular screening and treatment of such beggars. Those positive should be actively treated and their close contacts frequently screened. This hidden reservoir should be completely eliminated.

A leprosy survey in a taluk headquarters town and the role of dermatological services and active health education in its success--a preliminary report.

A report of two general surveys done in 1984 and 1987 in Gudiyatham town, is presented. The first survey covered 89.2% and the second survey 82% of the population. The new case detection rate was 3.4 per 1000. The success of the survey was due to the co-operation obtained from the public, most probably because of the intense and sustained health education, combined with leprosy services integrated with a dermatology clinic.