Leprosy Eradication Programme Research Articles

Leprosy in Post-elimination Era: A Study Conducted in Rural Tertiary Settings in North India.

Background Leprosy is an age-old disease caused by Mycobacterium leprae. The disease was declared eradicated in India in 2005. Many new cases are still being identified in the outdoor patient department. This study was undertaken to understand the epidemiological, clinical, and social aspects of leprosy among new patients, and assessthe current situation regarding caseload and presentation. Material and methods This study was designed as an observational study. It was carried out in people newly diagnosed with leprosyattending the outpatient department of Dermatology, Venereology, and Leprology in the tertiary care hospital in Uttar Pradesh University of Medical Sciences from July 2022 to January 2024. A total of 231 people afflicted with leprosy were included in the study. The data collected was statistically analyzed to identify demographic and social patterns, clinical presentations, and features associated with leprosy. Result Out of these 231 patients, 139 (60.17%) were male and 92 (39.83%) were female. Most cases belonged to the age group 40-59 years 87 (37.66%). History of close contact with an afflicted person was present in 34 (14.71%). Clinically, most patients belong to the borderline tuberculoid (BT) type. Only 24 (10.4%) patients were found positive for M. leprae by slit-skin smear examination. The ulnar nerve was the most common nerve involved in 63 (27.27%) cases. Trophic ulcers were the predominant deformity in 34 (14.7%), followed by foot drop in 13 (5.62 %). Conclusion The present study provides an overview of the prevailing trends of Leprosy within a specific region in the post-elimination era. The findings underscore the significance of the ongoing National Leprosy Eradication Program (NLEP) program and stress the importance of aligning them with the common goal of eliminating the burden and stigma of Leprosy from society.

Challenges of sustaining leprosy elimination in India and prospects of eradication: Current status & way forwards

Leprosy Elimination in India has been a public health priority for decades and on December 31, 2005, India achieved the World Health Organization’s (WHO) goal of eliminating leprosy as a public health problem at the national level, with the prevalence rate falling below one case per 10,000 population. Despite this, India still accounts for the highest number of new leprosy cases globally, contributing more than 50 percent of the leprosy burden of the world. The country has made considerable progress in reducing the burden of leprosy over the years but challenges remain in maintaining the elimination status and preventing disabilities due to leprosy. The present review discusses the current status of leprosy in India, identifies challenges/lacunae in the implementation of the leprosy eradication program, and suggests potential steps that could be undertaken for sustained elimination of leprosy and future possible eradication of the disease from the country.

Zero Leprosy Strategic Plans: Global and National Level: A Short Communication

Since the launch of multidrug therapy in 1982, the global leprosy situation has undergone significant changes, with the prevalence falling from over 5 million cases in the mid-1980s to <200,000 by the end of 2016. In India, the program reduced the prevalence rate from 57.8/10,000 in 1983 to <1/10,000 by the end of 2005, marking the achievement of the World Health Organizations (WHOs) target of eliminating leprosy as a public health issue. The WHO has recently introduced a new global leprosy plan called “Towards Zero Leprosy” as part of the disease-specific strategies outlined in the WHO's roadmap for neglected tropical diseases (NTDs) 2021–2030. This strategy aims to achieve interruption of leprosy transmission by 2030 and provides a framework for direction, objectives, challenges, and strategic pillars at a global level. In India, a committee of over 80 experts in the field of leprosy developed the National Strategic Plan and Roadmap for Leprosy 2023–2027, which was published on January 30, 2023. This policy is aligned with the WHO's NTDs roadmap 2021–2030 and the Global Leprosy Strategy 2021–2030, both of which aim to interrupt leprosy transmission by 2030. In this article, we have discussed the strategic plans of both the National leprosy eradication programme (NLEP) and the WHO.

Factors Associated with High Prevalence of Multibacillary Leprosy in West Bengal: A Case-Control Study.

High proportion of multibacillary (MB) among newly diagnosed leprosy cases poses a public health challenge. This study aimed to find out the factors associated with the high burden of MB leprosy in West Bengal. This case-control study was conducted from August 2020 to December 2022 in three high-endemic districts (annual new case detection rate ≥10/lakh) of West Bengal. MB cases registered under the National Leprosy Eradication Programme were considered as case and paucibacillary (PB) cases were considered as control. Weighted sample sizes for cases and controls in each of the three districts were selected using simple random sampling from the list of registered leprosy patients. Requisite data were collected through structured interview with a validated questionnaire in Bengali. R, version 4.1.1 (R Foundation for Statistical Computing, 2021, Vienna, Austria) was used for data analysis. A binary logistic regression model was prepared with the type of leprosy as a dependent variable. Three hundred and ninety-eight individuals, 204 MB and 194 PB, participated in this study with 1.97% nonresponse rate. Gender, marital status, and diagnostic delay (adjusted odds ratio = 2.75 [1.66,4.65]) were associated with developing MB. Not perceiving the symptoms seriously (90, 56% [PB], 97, 51% [MB]), lack of knowledge about the disease and its complications (47, 29% [PB], 53, 28% [MB]), delayed referral by the private practitioners (11, 7% [PB], 22, 12% [MB]) were the major reasons of delay. This study identified a vulnerable group - married and migrated males. Changing from annual screening to quarterly screening along with capacity building and awareness generation of the targeted population is the need of the hour for eradicating the disease.

Dermatology Photo Quiz 3

Leprosy has been prevalent in India for a very long time. To control the prevalence rate (PR) of leprosy in India, Government of India (GOI) launched “National Leprosy Control Programme (NLCP)” with Dapsone monotherapy in 1955. The PR in 1983 was 57/10000 population. In 1983 GOI launched “National Leprosy Eradication Programme (NLEP)” with "Multi Drug Treatment (MDT)”. PR came down to <1/10000 population in 2005. World Health Organization (WHO) declared leprosy was eliminated from India in 2005. Clinicians all over India are diagnosing leprosy cases and treating them. Multi Bacillary (MB) and Pauci Bacillary (PB) cases are commonly detected. Detection of new cases reminds us that transmission of leprosy is still active in the community. We are reporting a case of leprosy. Keywords: GOI, NLCP, NLEP, MDT, WHO, MB, PB

Scenarios warranting modified treatment regimens in leprosy: A 5-year retrospective study from a tertiary care center

Objectives: To study the scenarios warranting modified treatment regimens in leprosy. Materials and Methods: A 5-year retrospective study was carried out in a tertiary care center by analyzing the data collected from national leprosy eradication program (NLEP) records. Results: During the 5-year study period, 171 patients received treatment for leprosy from our center. Thirtyone patients (31/171, 18.1%) required substitution of standard multidrug therapy (MDT) with alternate drugs or required alternate treatment regimens. The patients who required modified treatment included 18 men (18/31, 58.1%) and 13 women (41.9%). Male/female ratio was 1.4:1. Indications for treatment modification were adverse drug reactions to standard MDT (ADR) (21/31, 67.7%) and lack of response to standard MDT (10/31, 32.3%). The most common scenario that warranted a modification of standard MDT was dapsone-induced hemolysis (12/31, 38.7%). Seven (7/31, 22.6%) and two (2/31, 6.5%) patients needed a change in treatment due to drug-induced hepatitis and drug-induced maculopapular rash, respectively. Limitations: Retrospective study design, study conducted in single tertiary referral center and small sample size were the limitations. Conclusion: Nearly one-fifth of patients with leprosy required modifications in standard MDT. The most common indication (in two-third of patients who needed a modified treatment) for modification of treatment regimen was adverse drug reactions.

A cross-sectional study on burden of disability among leprosy patients in a tertiary care center of West Bengal, India

Background: Leprosy, an infectious disease caused by Mycobacterium leprae, mainly affects skin, peripheral nerves, mucosa of the upper respiratory tract, and eyes. New goal of the WHO is to decrease the rate of disabilities in new cases among 10 lakhs population 35% with compare to base line 2010. Burden of disabilities continues to rise in society and they are in need of prevention and/or rehabilitation services. Prevention of disability consists of early detection and treatment of reactions and nerve damage. Aims and Objectives: The objectives of the study were to find out the proportion of disability among leprosy cases and the factors associated with disability. Materials and Methods: This observational, cross-sectional, and descriptive study was conducted at Dermatology, Venerology, and Leprosy Department of a tertiary hospital from May 2015 to January 2016. Data were collected from all the study population by interviewing the study subjects and clinical examination of patients with pre-designed and pre-tested schedule and disability assessment form available from National leprosy eradication program (NLEP). Skin examination was done as per NLEP guideline and palpation of all the nerve and function of the nerve by voluntary muscle testing (VMT) done as stated national guideline. Data were analyzed using R Studio. Results: Among the study population, 87.9% of patients had disability and 61.7% of patients had Grade 2 disability. EHF score of most of the patients (59.8%) was ranged between 4 and 6. Among participants 33.6% had foot ulcer, 28% had ulnar claw hand, and 15.6% had lagophthalmos. Proportions of the upper limb digit loss, median claw hand, wrist drop, foot drop, and lower limb digit loss were 5.6%, 13.1%, 3.7%, 9.3%, and 12.1%, respectively. Conclusion: The present study reflected that a large number of cases with leprosy have presented with complication and disability. There was significant association of disability with multibacillary cases, number of nerve thickening, and number of functionally impaired nerve as assessed by VMT, lepra reaction, presence of nodular skin lesion and patch in skin and delayed initiation of treatment since the onset of symptoms.

Implementation of National Leprosy Eradication Programme during COVID-19 era: A qualitative research.

Introduction The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis.

Spatial Modeling of leprosy disease in east java province with spatially varying regression coefficients models.

Indonesia ranks third with the most leprosy cases globally. East Java is the province that has the highest leprosy cases. The Provincial Government socialized the East Java Leprosy Eradication Program, which targets a maximum of one leprosy case per 10,000 residents. We propose spatially varying regression coefficients models to evaluate the effects of risk factors on of leprosy cases in East Java, use Geographically Weighted Generalized Poisson Regression and Geographically Weighted Negative Binomial Regression (GWNBR) models. The best models GWNBR categorize municipalities into six groups based on variables that have a significant impact on leprosy cases. The percentage of households with access to adequate sanitation is a significant factor in determining leprosy cases in all municipalities in East Java. We can conclude that clean and healthy living behavior, health facilities, and health workers significantly affect the number of leprosy cases in East Java.

A comparison of three types of targeted, community-based methods aimed at promoting early detection of new leprosy cases in rural parts of three endemic states in India.

BackgroundIndia achieved elimination of leprosy nationally in 2005, but since then the number of patients with grade 2 disability at diagnosis increased steadily indicating delay in diagnosis. Therefore, there was a need for public health interventions which can increase case finding in their earlier stage. The objective of this study is to compare the effectiveness of three such community-based interventions; 1) Enhancement of community awareness on leprosy; 2) Education and motivation of “Index” leprosy cases; and 3) Involvement of Non-Formal Health Practitioners (NFHPs) to promote early detection of new cases of leprosy.Methodology/principal findingsThree community-based interventions were implemented between April 2016 and March 2018, embedded within the National Leprosy Eradication Program (NLEP) of India. Interventions were 1) increasing awareness through involvement of Gram Panchayat (local government) in the community regarding early signs of leprosy (Awareness), 2) providing health education and motivating newly diagnosed leprosy patients to bring suspects from their contacts (Index) and 3) training local non-formal health practitioners (NFHP). Each intervention was implemented in a group of ten blocks (sub-division of district) with an additional ten blocks as control (with no intervention). The main outcomes were number of new cases detected and number of grade 2 disability among them. They were obtained from the routine NLEP information system and compared between these interventions. On an average, there was an addition of 1.98 new cases in Awareness blocks, 1.13 in NFHP blocks and 1.16 cases in Index intervention blocks per month per block after adjusting for changes in control blocks during the same period. In terms of ratio, there was a 61%, 40% and 41% increase in case notification in awareness, Index and NFHP intervention, respectively. Overall, the percentage of grade 2 disability across intervention blocks declined.ConclusionThe Awareness intervention appears to be more effective in detection of new cases, compared to Index case motivation and sensitization of NFHPs. However, it is important to stress that while selecting strategies to increase early diagnosis it is important to determine, which is the most appropriate for each context or area and must be decided depending on the local context.

Neutrophil NETworking in ENL: Potential as a Putative Biomarker: Future Insights.

Erythema nodosum leprosum (ENL), also known as type 2 reaction (T2R) is an immune complex mediated (type III hypersensitivity) reactional state encountered in patients with borderline lepromatous and lepromatous leprosy (BL and LL) either before, during, or after the institution of anti-leprosy treatment (ALT). The consequences of ENL may be serious, leading to permanent nerve damage and deformities, constituting a major cause of leprosy-related morbidity. The incidence of ENL is increasing with the increasing number of multibacillary cases. Although the diagnosis of ENL is not difficult to make for physicians involved in the care of leprosy patients, its management continues to be a most challenging aspect of the leprosy eradication program: the chronic and recurrent painful skin lesions, neuritis, and organ involvement necessitates prolonged treatment with prednisolone, thalidomide, and anti-inflammatory and immunosuppressive drugs, which further adds to the existing morbidity. In addition, the use of immunosuppressants like methotrexate, azathioprine, cyclosporine, or biologics carries a risk of reactivation of persisters (Mycobacterium leprae), apart from their own end-organ toxicities. Most ENL therapeutic guidelines are primarily designed for acute episodes and there is scarcity of literature on management of patients with chronic and recurrent ENL. It is difficult to predict which patients will develop chronic or recurrent ENL and plan the treatment accordingly. We need simple point-of-care or ELISA-based tests from blood or skin biopsy samples, which can help us in identifying patients who are likely to require prolonged treatment and also inform us about the prognosis of reactions so that appropriate therapy may be started and continued for better ENL control in such patients. There is a significant unmet need for research for better understanding the immunopathogenesis of, and biomarkers for, ENL to improve clinical stratification and therapeutics. In this review we will discuss the potential of neutrophils (polymorphonuclear granulocytes) as putative diagnostic and prognostic biomarkers by virtue of their universal abundance in human blood, functional versatility, phenotypic heterogeneity, metabolic plasticity, differential hierarchical cytoplasmic granule mobilization, and their ability to form NETs (neutrophil extracellular traps). We will touch upon the various aspects of neutrophil biology relevant to ENL pathophysiology in a step-wise manner. We also hypothesize about an element of metabolic reprogramming of neutrophils by M. leprae that could be investigated and exploited for biomarker discovery. In the end, a potential role for neutrophil derived exosomes as a novel biomarker for ENL will also be explored.

Childhood leprosy. A retrospective analysis.

The implications of leprosy detected in a child are numerous. Apart from making it mandatory to search for the source in the family, it indicates continued transmission of the disease in the community and thus poses a great hurdle in achieving the targets laid by World Health Organization (WHO) and National Leprosy Eradication Programme (NLEP) in the direction of leprosy elimination. In spite of an effective treatment and the tireless work of various government and non government organizations, the number of childhood cases have not drastically reduced. Elimination of childhood leprosy needs to get the highest priority, not only because of the physical deformities and disabilities but also because of the psychological trauma it causes due to the social stigma attached to it. So we undertook a retrospective study of 5 years from 2015 to 2020 retrieved from the departmental data involving all diagnosed leprosy cases below 18 years of age and studied their clinical spectrum, histopathology and treatment outcomes. In our study, the mean age at the time of diagnosis was 12.95 years. Borderline tuberculoid was the most common type of leprosy in 61.9% of cases. 19.04% had lepra reactions and 14.6% had deformities in the form of claw hand and nerve abscess. The overall incidence of childhood cases was 17.07% that was much higher in comparison to the national figure of 6.87%, probably owing to the small sample size and as the study was conducted in an endemic area. This study highlights the fact that leprosy, especially in children, appears to be far from the point of elimination and a stringent strategy is required to achieve the goal of its eradication.

Current scenario of leprosy in post elimination era at a tertiary care hospital in central India

Background: Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae primarily affecting the skin and peripheral nerves. Though India announced statistical elimination of leprosy as public health problem under the National Leprosy Eradication Programme in December 2005, still wide variations exist in prevalence rates of this disease across the country. Objectives: Of the study were to determine the pattern, occurrence and trends of smear positive leprosy cases at Government medical college, Akola. Materials and Methods: This is a retrospective study conducted from January 2018 to February 2020. All patients suspected of leprosy were confirmed by slit skin smear examination. Record details of age, type and duration of disease, deformity status were noted. Results: Total 520 clinically suspected were examined. 175 were diagnosed smear positive foe acid fast bacilli. Males outnumbered females. Smear positivity was highest in 21- 40 years age group. Multibacillary cases were 103(58.85%) and paucibacillary were 72(41.14%). Interpretation and Conclusion: Present study shows that despite statistical elimination, leprosy still continues to be a challenge. Approaches like destigmatising the disease, family counseling, integrating leprosy care into general health care systems, developing newer diagnostic and epidemiological tools, chemoprophylactic regimens and vaccines are needed to develop eradication strategy that can reduce the burden of leprosy in India. Keywords: Leprosy, Acid fast bacilli, Smear positive cases.

Awareness of Leprosy in an urban slum of Western Maharashtra Post 35 Years of the National Leprosy Eradication Program (NLEP)

BackgroundEven after 35 years of the National Leprosy Eradication Program (NLEP) and 15 years post-elimination, leprosy continues to be a public health challenge in India. This paper discusses the current awareness of leprosy among people living in urban slums of western Maharashtra. MethodsThe study was conducted in an urban slum of western Maharashtra with 400 participants. A closed-ended questionnaire regarding the knowledge, attitude, practices, and stigma existing among the people was administered, followed by a small awareness talk and screening for leprosy. ResultsOf the total 400 participants, 205 (51.25) were females and 195 (48.75) were males. Only 154/400 (38.5%) people were aware of leprosy. 130/400 (32.5%) people thought that it is treatable; however, 71/130 (54.6) of them thought that it would recur even after completing the treatment. Only 103/400 (25.75) said that they would marry a person with leprosy, denoting prevalent stigma in the society, and 79/400 (19.75) were aware of government services for leprosy and NLEP. Screening of all the participants surveyed did not reveal any new or doubtful cases of leprosy. ConclusionThe present study shows a lack of awareness and knowledge of leprosy among the target population. With only 20% of them being aware of government services and the NLEP, combined with an extremely low knowledge about the disease; it shows the need to further augment the government programs. There is also an increasing need to educate people to accomplish a positive attitude of the community towards leprosy patients.

A Case of Histoid Hansens Mimicking as Neurofibroma in Presentation in a Post Elimination Era

Histoid leprosy is an unusual leprosy variety generally following the failure of therapy. It occurs de novo from time to time with a history of insufficient or improper treatment. In this case report a case of such a presentation of histoid leprosy mimicking as neurofibroma in 25-year-old male patient of Kalaburagi region in post elimination era is presented. The frequency of leprosy of 0.6210000 had been recorded in March 2017 National Leprosy Eradication programme NELP.nbsp

Cost-effectiveness of incorporating Mycobacterium indicus pranii vaccine to multidrug therapy in newly diagnosed leprosy cases for better treatment outcomes & immunoprophylaxis in contacts as leprosy control measures for National Leprosy Eradication Programme in India.

Background & objectives:The elimination goal for leprosy as a public health problem at the national level was achieved in 2005 in India. However, the number of new cases reporting annually remained nearly the same during the last 10-15 years. Moreover, a substantial number of these new cases reported disabilities for the first time. Therefore, besides multidrug therapy (MDT), newer strategies with focus on effectively decreasing the number of new cases, optimizing the treatment of detected cases, averting disabilities and arresting the transmission of the disease are required. So the objective of this study was to assess the cost-effectiveness of Mycobacterium indicus pranii (MIP) vaccine implementation in National Leprosy Eradication Programme (NLEP) for newly diagnosed leprosy patients as well as their contacts to arrest/decrease the transmission and occurrence of new cases.Methods:This was a model-based estimation of incremental costs, total quality-adjusted life years (QALYs) gained, new cases averted, deaths averted, incremental cost-effectiveness ratio (ICER) and budget impact of the vaccination intervention. This model included the addition of MIP treatment intervention to the newly detected leprosy patients as well as vaccination with MIP to their contacts.Results:Using the societal perspective, discounted ICER was estimated to be ₹73,790 per QALY gained over a five-year time period. Probabilistic sensitivity analysis (PSA) was assessed by varying the values of input parameters. Majority (96%) of simulations fell in North East quadrant of cost-effectiveness plane, which were all below the willingness to pay threshold.Interpretation & conclusions:Introduction of MIP vaccination in the NLEP appears to be a cost-effective strategy for India. Significant health gains were reduction in the number of new leprosy cases, decreased incidence and severity of reactions during treatment, and after release from treatment, prevention of disabilities, thus reducing the cost as well as stigma of the disease.

Evaluation of impact of national leprosy eradication programme in a community health centre in Eastern India

Background & Aim: Leprosy a chronic infectious public health challenge is caused by a slowly multiplying acid fast bacillus Mycobacterium leprae. An untreated leprosy-affected person is the only known source of infection. Our aim was to study the trend in the prevalence of leprosy in the health care facility, to compare the leprosy burden in urban and rural field practice area under the health facility, to identify any gaps/loopholes in the implementation of the NLEP and to recommend remedial measures to address the gaps. Materials and Methods: A cross sectional study was conducted at Community Health Centre Jatni, Khordha, Odisha during the year 2018-19. A pre-designed questionnaire, personal interview with multipurpose health worker male and review of leprosy records of different years was used as study tool. Results: Majority i.e., 78.6% of the leprosy patients were from rural areas. Overall male predominance of the cases was found both in urban & rural areas. More numbers of cases were registered during 2014-15 & 2015-16 which was declined in 2016-17, but again increased in the subsequent years i.e., 2017-18 and 2018-19. 61.8% diagnosed leprosy cases had successfully undergone treatment and got cured and 24.4% of the cases were the defaulters to MDT. Conclusion: Defaulter cases are the major source of continuous transmission of infection in the community. Active surveillance for Leprosy is to be strengthened in both rural and urban areas with special focus on IEC and BCC activities along with proper counseling of the family members with involvement of community people. Keywords: NLEP, MDT, LCDC.

Accelerating towards a Leprosy Free India through innovative approaches in the National Leprosy Eradication Programme (NLEP), India

India is the country with the highest burden of leprosy in the world. In 2015–16 because new case detection remained persistent and the rate of Grade 2 Disability (G2D) in new cases was rising, new initiatives to promote early case detection were developed. The new measures and the indicators being used to monitor progress towards the goal of a leprosy free India are described.

Spectrum of leprosy among suspected cases attending a teaching hospital in Western Rajasthan, India.

Background:Leprosy is a chronic granulomatous infectious disease, which mainly involves skin, peripheral nerves, mucosa of the upper respiratory tract, and eyes. According to National Leprosy Eradication Programme 2017–18 annual report, the annual new case detection rate from Rajasthan is 1.27 per 1 lakh population and prevalence rate is 0.14.Aims and Objective:The main objective of this study was to determine the spectrum of Mycobacterium leprae infections among suspected cases attending a teaching hospital in western Rajasthan, India.Materials and Methods:This is a retrospective study conducted in the Department of Microbiology, in a teaching hospital, western Rajasthan, between the period of January 2017 and April 2019. The records of modified Ziehl–Neelsen staining during the study period were analyzed. The demographic data like age and sex along with clinical diagnosis were also recorded from laboratory register and hospital information system.Results:Out of total 91 suspected cases, 30.77% was microbiologically confirmed cases of leprosy. Out of total positive cases, 71.43% were male and 28.57% were female. A maximum number of positive (50%) were found in the age group of 31–50 years.Conclusion:Present study gives an insight about the spectrum of leprosy in the region. The large number of positive cases signifies that leprosy awareness and programs aimed at elimination need to be more vigorously implemented. To achieve complete eradication from this menace, newer strategies like effective vaccine development and drug-resistance testing should be implemented.

At kalde sygdommen ved dens rette navn. Om spedalskhed i Sydindien

The article focuses on communication in a medical anthropological context. Based on empirical data from a leprosy eradication programme in Tamil Nadu in India, it is indicated how the terminology and the semantics of the sickness influence the medical work. During the fieldwork, 3 biomedical synonyms and 24 Tamil layterms were registered. The choice of label for the ailment in question had clear implications for health education activities, population surveys, as well as treatment compliance.