Utilizing primary health care workers for case detection.

Under the National Leprosy Elimination Programme it takes at least one year for the paramedical worker to survey the allotted population for case detection. An alternative strategy in warranted for States like Bihar still having a high case load and poorly functioning leprosy programme. An intensive case finding programme using Primary Health Care (PHC) workers was organized in Bhojpur district, Bihar State, India. The whole population (3, 173, 701 in 1996) of the district was screened within a period of four days and confirmation of suspected cases was carried out in four days. During this screening procedure, 1586 new leprosy cases were detected (NCDR = 5 cases per 10,000) and all were started on MDT. The new cases constituted 26.4% of active cases existing on record before the screening. After this experience, the prevalence rate of active cases increased from 19 to 24 10,000. If such rapid screening programmes are done at least twice a year, it will greatly hasten the process of elimination of leprosy.

A study on the effect of patient and community education in prevention of disability programme.

The effect of self-care learning by leprosy patients in prevention of disabilities was studied by adapting two strategies in two subcentres of a project in South India, one through patient education by trained field staff and the other through community education involving trained animators and health committees. One of the subcentres was taken as control where neither of the strategies was employed. In terms of results, though both the strategies were found to be effective in containing occurrence of new deformities among high risk patients and healing of trophic ulcers in hands and feet, strategy I i.e. self-care education of patients by concerned field personnel without prejudice to their routine work is recommended because of ease in diffusion of strategy.