Dip in Maharashtra’s leprosy numbers suspicious: experts

For the first time since 2007, Maharashtra’s leprosy numbers have dropped, according to State public health department figures accessed by The Hindu . Experts, however, suspect the dip to be a result of under-reporting of the disease rather than a genuine decline.

A total of 12,416 new leprosy cases were detected between April and December 2013 — 1,379 cases per month. However, in the 12-month period from April 2012 to March 2013, 18,715 new cases were reported — a total of 1,560 cases per month.

While health authorities claimed the fall was the result of an effective leprosy eradication programme, experts did not share the view. “The State is in a hurry to report the elimination of the disease, thus ignoring many genuine cases,” said Sheetal Amte of Anandwan, a centre for leprosy patients founded by Magsaysay award winner Baba Amte.

In 2007, the State declared it had eradicated leprosy as the numbers were within the WHO standard of disease elimination. The figures remained within the standard till 2012, despite a rise in new cases. That year, however, the numbers surpassed the WHO standard. Experts claim under-reporting by authorities to maintain the WHO standard led to the decline.

According to WHO standards, there should be only 1 case of the disease per 10,000 people in a country for it to be declared eradicated.

In 2012, the prevalence of leprosy rose from 0.93 to 1.07 per 10,000 people. In 2013, it jumped to 1.09. However, health officials, who have denied allegations of under-reporting, claimed that going by current figures the prevalence was expected to dip to 1.01.

“The fall in leprosy numbers is good news. We have put in a lot of effort to maximise reporting and treatment. We will gradually see a decline,” said Manohar Pawar, joint director of the State health department’s leprosy programme.

Incidentally, the officials rely on cases reported by people to assess the prevalence of the disease. They said door-to-door leprosy surveys were scrapped due to shortage of manpower. In 2007, health workers in the leprosy programme were integrated into the health department, leaving no dedicated staff for leprosy detection and treatment. Officials admit that this strategy may have influenced the numbers.

“Given the stigma attached to the disease, people still hesitate to come forward and report it. We are now relying on community participation to draw up figures,” said Mr. Pawar.