ABSTRACT
The authors make an inventory of the difficulties they have met while realizing the different stages of MDT treatment programmes in Senegal. Main problems were: Necessity of complementary training on theoretical, but even more on practical techniques for all the staff: Ridley and Jopling classification, neurological examination, bacteriological examination, data collection. Difficulty to maintain a true supervision. Necessity to settle a quality control of slit skin smears. Necessity to settle a system to trace irregular patients. Heaviness of centralized management, but its necessity to maintain "tightness" of the drugs distribution network. Difficulty to obtain a regular follow up of patients who are released for treatment. The evolution of anti-leprosy activities makes it necessary to adapt the "Service des Grandes Endémies".
