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SHORT COMMUNICATION
Year : 1994  |  Volume : 60  |  Issue : 5  |  Page : 280-282

Mono lesions in leprosy - An indicator of the MDT programme evaluation




Correspondence Address:
Paramjit Kaur


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Source of Support: None, Conflict of Interest: None


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  Abstract 

Prevalence of monolesions in leprosy was studied in the leprosy control units of an MDT district before the start of MDT programme and at the end of 3 years. The percentage of mono lesions in new cases detected increased from 21.7% to 33.3% in under 15 years age group and from 9.6% to 15% in over 15 years group at the end of 3 years. This increase indicates some success of the programme.



How to cite this article:
Kaur P, Kaur V, Singh G. Mono lesions in leprosy - An indicator of the MDT programme evaluation. Indian J Dermatol Venereol Leprol 1994;60:280-2

How to cite this URL:
Kaur P, Kaur V, Singh G. Mono lesions in leprosy - An indicator of the MDT programme evaluation. Indian J Dermatol Venereol Leprol [serial online] 1994 [cited 2020 Nov 24];60:280-2. Available from: https://www.ijdvl.com/text.asp?1994/60/5/280/4076



  Introduction Top


Monolesions in leprosy may be a feature of indeterminate leprosy, tuberculoid leprosy and a proportion of borderline tuberculoid leprosy. In an endemic country where extensive treatment programme is going on, a high percentage of monolesions is an important indicator of the programme success.

We are reporting the rates of monolesions before the start of MDT project in the district of Faizabad and its impact on the rate of detection of monolesions 3 years after the start of MDT in the district.


  Materials and Methods Top


MDT project was started in Faizabad in the year 1988 and actual drug treatment started in April 1989. The data presented is based on the records maintained by the leprosy control units of the district.


  Results and Comments Top


In this district percentage of cases with monolesions at the time of initial survey had been 21.7% in under 15 population and 9.6% in the adults.

The percentage of monolesional cases had gradually increased from 21.7% in 1988 to 33.3% in 1993 in under 15 and from 9.6% in 1988 to 15% in 1993 in the adults [Table - 1].

Even in early 80's a whole population survey of rural areas of Pondicherry revealed 60.2% having only single lesions. [1] Such high figures have also been observed in childhood leprosy. [2],[ [3] In the armed forces where there is regular annual medical check up 59.8% of the non-lepromatous cases had single lesions at the time of detection. [4] These high figures of monolesional leprosy are from the population which had been under constant surveillance.

In our MDT district though the contact survey is supposedly a regular feature but most of the cases were self reported and that is why most of them had been established cases of leprosy. Examination by the consultant leprologist had shown a high index of accuracy. If the clinical accumen of staff is poor then there is a high risk of over diagnosis. It is relatively easy to diagnose a case of tuberculoid leprosy since there is a near complete loss of sensations. Tuberculoid cases however constitute only less than half of the monolesional leprosy. [4]

In the beginning of the programme both new and old cases are detected. Gradually more newer cases are detected and so there is an increase in the single lesion cases.

The data from the district under study shows a very slow increase in the percentage of single lesion cases [Figure - 1]. This shows that the programme is picking up but not to the desired expectations. This is due to the fact that school surveys are not conducted, contact surveys are inadequate and our workers depend mostly on voluntary reporting of patients. The populations not having enough health education and with a fear of stigmatization, even though it has been grossly reduced, postpone reporting till the disease advances. Trend in the proportion of single lesion cases in a population under MDT is of help in understanding disease process provided rigorous case detection is conducted[5].

 
  References Top

1.Reddy BN, Bansal RD. An epidemiological study of leprosy in a rural community of Pondicherry. Indian J Lep 1984; 56 : 15-23.  Back to cited text no. 1  [PUBMED]  
2.Ganpati R, Naik SS. Childhood leprosy prevalence rates and clinical aspects through school survey. Leprosy in India 1976; 48 645-60.  Back to cited text no. 2    
3.Selva Pandian AJ, Jayaprakash U, Abraham J, Kuppuswamy P, George M. School survey in rural leprosy endemic area. Leprosy in India 1980; 52 : 209-16.  Back to cited text no. 3    
4.Guha PK. Clinical Epidemiology of non­lepromatous leprosy among service personnel. Leprosy in India 1982; 54 : 512-7.  Back to cited text no. 4  [PUBMED]  
5.Krishnamurthy P, Rao PS, Subramaniam M, et al. The influence of operational factors in the profile of monolesional leprosy cases in South India. Lepr Rev 1994; 65 : 130-1.  Back to cited text no. 5    


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    Tables

[Table - 1]



 

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