From being a high endemic district for leprosy in Tamil Nadu in 1983, Vellore has become one of the regions of low prevalence of the disease in the State. While “vigorous activities” helped in scaling down the number of cases, officials say concerted efforts are needed to eradicate it completely.
In 1983, Vellore district accounted for 25,000 cases per year for a population of 38 lakh. The same year saw the launch of the National Leprosy Eradication Programme (NLEP), with Vellore being the only district in Tamil Nadu, and one of six endemic districts in the country to be selected for the programme, officials said.
‘Efforts paying off’
“The prevalence was 118 cases per 10,000 then. Following vigorous activities taken up under NLEP, the prevalence was brought down to below 10 per 10,000 in 1997. The number of cases fell from 25,000 to 2,000 per year in 1997 (7 per 10,000),” S. Mohammed Afzal Ali, deputy director, Leprosy, Vellore said.
As the prevalence came down in 1997, the World Health Organisation decided that the mechanism for detecting leprosy cases should be widened by involving primary health care centres and governments hospitals. Consequently, leprosy was brought down under the public health care system.
Presently, there are 150 to 180 newly cases every year in Vellore district, said J. Vetriselvi, medical officer, Leprosy. “The number of newly detected cases per year continues to be the same for the last four to five years,” she said. The present prevalence (2017) stood at 0.4 per 10,000. At the heart of leprosy care is a district nucleus team that comprises a deputy director, medical officer, non-medical supervisor, physiotherapy technician and health inspector. From the field-level experience of the team members, the awareness of leprosy has definitely increased, and this was evident from the number of people voluntarily seeking treatment.
Fear of stigma
People have been seeking medical help for one of the earliest signs of leprosy — hypo-pigmented patches with loss of sensation. Yet, the element of fear haunts many of them as leprosy continues to be a stigmatised disease, he added.
One of the main challenges faced by medical staff was compliance with treatment, and the acceptance level continues to be low due to the stigma attached to the disease, they say.
“But with Multi Drug Therapy (MDT), leprosy was 100% curable. With early diagnosis and regular treatment with MDT, we can prevent deformity and cure leprosy. The present cure rate is 97%,” he said.
Care does not stop with drugs. “We provide two pairs of micro cellular footwear every year. After they complete treatment, they can undergo reconstructive surgeries for deformities free of cost. After surgery, we pay them ₹8,000 as incentive,” V.N. Gangadharan, non-medical supervisor, Leprosy, said.
“More staff should be posted. Out of the 33 districts in TN, only some have deputy directors for leprosy. The district nucleus team should be strengthened. The transportation for the team should be improved,” he said.
