Response of thickened nerve trunks and skin lesions of leprosy patients to MDT.

This paper indicates the responses of thickened nerve trunks in leprosy patients to MDT. Out of 1625 cases, 557 (34.2%) cases had thickened nerve trunks at the time of registration. From these cases, 175 (31.4%) were randomly selected and re-examined by personal visit about 5 years after RFT. Follow-up showed persistent thickening in 96 (54.8%) cases. Persistence of nerve thickening was higher in MB leprosy. Additional nerve thickening appeared in 8 (4.6%) cases. New disability developed in 6 (3.4%) cases after RFT but these persons did not come for check up voluntarily. Reaction occurred in 6 during follow-up. Both MB and PB considered together thickening continued in as high as 96 (54.8%) compared to persisting skin lesions in 24 (13.7%) cases. Persons with thickened nerve trunks require more counseling to report for check up at the earliest sign of nerve function deficit.

A review of trends in new case-detection in Subarnapur district of Orissa.

Trends in new case-detection are analysed by reviewing the demographic and leprosy epidemiological data and current indicators in Subarnapur district, Orissa State and India. Population-specific new case-detection rates were calculated for analysis. The trend of skin-smear positive cases over a period of 10 years was reviewed in respect of smear positive cases of 1991. During the years 2002 to 2004, a sudden fall was noticed in the new cases detected in both India and Orissa state, whereas the decline in Subarnapur district was more gradual. The fall in the female-specific new case-detection rates is found to be rapid from 11 to 2.5 over the last three years. This also indirectly indicated the health-seeking behaviour of women in accessing health services and hence required a changed strategy. A similar rapid decline was observed in child-specific new case-detection rates. On analysiS, the decline of highly bacilliferous cases from 1991 to 2001 was found to be statistically significant. The analysis also brought out the fact that cases with bacterial index of 1+, 2+ and 3+, though small in numbers, were detected during the last three years indicating continued presence of cases with low bacterial density in the community. The review indicates a definite decline in the occurrence of new cases in all groups. Caution needs to be exercised about continued presence of cases with low bacterial index though in small numbers. The rapid decrease of cases in all groups during the years 2004 and 2005 warrants meticulous surveillance. The surveillance activities could include monitoring of population-specific new case-detection rates and skin-smear positive cases at district and state levels in order to advise on leprosy eradication programme strategies.