A Cross-Sectional Study of the Success of the Leprosy Elimination Strategy before and after a 10-Year Eradication Period in a Referral Hospital in Tamil Nadu, India

Objective: To assess the successes of the leprosy elimination strategy before 2000 to 2005 and after the eradication period from 2006 to 2010 in a referral hospital in the Tamil Nadu district, India.

Background: The elimination strategy is based on detecting and treating all leprosy cases with Multi Drug Therapy (MDT) and thereby reducing the disease burden to a very low level. The key is to ensure that all new cases continue to have access to MDT services. A significant proportion of patients in Kerala and a few other states did not get MDT in the nearest health facility, and there was no patient counselling in most states.

Methods: A retrospective cross-sectional study was conducted on all registered new cases of leprosy over a ten-year period at the referral Sacred Heart Leprosy Hospital in Kumbakonam, Tamil Nadu.

Results: During the survey, a total number of 5,794 new leprosy cases were registered from 2000 to 2010 between before and after the eradication period at a referral leprosy hospital. Comparative analysis of 5 years before and after the eradication period surveys show that the total number of multibacillary and paucibacillary cases registered before eradication was 4177and after eradication it was reduced to 1617, in that multibacillary cases reduced from 2724 to 1150 after eradication and paucibacillary cases reduced from 1453 to 467 cases. According to this analysis, it is concluded that the total number of leprosy cases reported in referral hospitals per day before eradication was 2.28 and after eradication, it was reduced to 0.88 cases per day. It is hoped that active surveillance screening will ensue along the districts so that cases of leprosy can be detected before people suffer the long-term consequences of the disease. So earlier treatment and awareness for leprosy is a better way to decrease the disease.

Conclusions: In certain parts of Tamil Nadu, south India, leprosy was out of control and remained a significant public health concern. Though there is still a chance of leprosy cases in endemic areas following the eradication period, leprosy elimination is clearly in sight. Thus, community-based surveillance and leprosy awareness days may contribute to better leprosy early identification, treatment, case holding, and prevention of impairments. Increasing awareness programs in endemic districts is a very effective method to decrease leprosy.