Gender and leprosy: case studies in Indonesia, Nigeria, Nepal and Brazil.

There appear to be regional differences in gender ratios of leprosy patients being diagnosed and treated. In Asian countries, more men than women are registered whilst in Africa female patients outnumber males. The Netherlands Leprosy Relief (NLR) therefore initiated research into factors underlying these regional gender differences. Between 1997 and 1999, leprosy control teams in Indonesia, Nigeria, Nepal and Brazil supported by social/public health scientists, conducted comparative exploratory research. They looked at three groups of potential explanatory factors: biological, socio-cultural/economic and service-related. The studies were partially quantitative (analysis of the records of patients who according to prescription could have completed treatment) and partially qualitative (interviews/focus group discussions with patients, their relatives, community members and health staff on perceptions of leprosy, its socio-economic consequences, treatment and cure). Biological factors appeared similar in the four countries: irrespective of the M/F ratio, more men than women were registered with multibacillary (MB) leprosy. Strong traditions, the low status of women, their limited mobility, illiteracy and poor knowledge of leprosy appeared to be important sociocultural factors explaining why women were under reporting. Yet, accessible, well reputed services augmented female participation and helped to diminish stigma, which in three out of the four societies seemed greater for women than for men. These positive effects could still be higher if the services would enhance community and patient education with active participation of patients and ex-patients themselves.

Panel 2.2: surveillance, early warning alert, and response: communicable and vector-borne diseases.

This is a summary of the presentations and discussion of Surveillance, Early Warning Alert and Response at the Conference, Health Aspects of the Tsunami Disaster in Asia, convened by the World Health Organization (WHO) in Phuket, Thailand, 04-06 May 2005. The topics discussed included issues related to the surveillance, early warning alert, and response to communicable and vector-borne diseases as pertaining to the responses to the damage created by the Tsunami. It is presented in the following major sections: (1) key questions; (2) needs assessment; (3) coordination; (4) gap filling; and (5) capacity building. The key questions section is presented in six sub-sections: (1) communicable diseases; (2) early warning; (3) laboratory capacity and referral networking; (4) coordination of disease surveillance, early warning, and response; (5) health infrastructure rebuilding; and (6) using existing national surveillance plans to enhance disease surveillance and early warning systems.