Preventing leprosy-related disabilities in children #ZeroDisabilities #ZeroLeprosy
1 February 2018, Vientiane Capital - The Ministry of Health conducted a review meeting to discuss the results from an intensified leprosy case findings activity that took place in Xiengkhuang Province in December last year. This review activity coincides with the World Leprosy Day that was marked on the last Sunday of January.
The Minster, Dr Bounkong Syhavong joined by WHO Representative, Dr Juliet Fleischl and Director of the National Dermatology Centre and Head of the National Leprosy Control Programme, Dr Sisavath Manivong discussed about lessons learnt and the advantages of these surveillance activities that promote early detection in preventing disability.
This fits with the theme for this year, which is “Proactive detection and early diagnosis of leprosy to achieve Zero Disabilities in girls and boys.” Since the introduction of the Multidrug Therapy (MDT) in the 1980s, effective chemotherapy of over 16 million patients has significantly reduced the number of new cases and disabilities.
WHO has been working with the National Leprosy Control Programme since 1991 to make MDT available in the country. A report in 2016 has confirmed that the National Leprosy Programme in Lao PDR has continuously made significant progress in reducing the leprosy burden.
The new cases with grade-2 disabilities has fallen from 20 cases in 2015 to 18 cases in 2016; meeting the Ministry of Health’s goal for leprosy control in Laos. In 2017, new grade-2 disabilities remain at 18 cases. The proportion of children cases has increased from 4.6 per cent (3 child patients) in 2016 to 7 per cent (6 child patients) in 2017.
To address childhood leprosy and grade-2 disabilities, the programme needs to reach the poor, under-served, vulnerable and marginalized communities, and to improve their access to health services. Moreover, the Multi Bacillary (MB) number is also increasing from 50 cases (64 in total) in 2016 to 63 cases (90 in total) in 2017 indicating that active transmission is still on-going at the community level.
The team from the National Dermatology Centre that visited Xiengkhuang Province for intensified case findings activities detected 22 new cases in early stages; none of these cases have any signs of disability. This shows the importance of surveillance activity to detect cases early so as to prevent leprosy-related disability.
To address the challenges faced by the leprosy programme, the latest 2016-2020 leprosy strategy included more innovative and inclusive medical and social components while highlighting the focuses on children, women and other vulnerable populations. It would integrate referral within the health system strengthening strategy, systematic tracing of contacts and households affected by leprosy, drug resistance monitoring, simplified treatment approach and post-exposure prophylaxis.
It is built around 3 pillars: to strengthen government ownership, coordination and partnership; to stop leprosy and its complications; and to stop discrimination and promote inclusion. The strategy aims for zero children with leprosy-affected disabilities, a reduction of new patients diagnosed with leprosy-related deformities to less than one per million populations and on developing legislation that will stop the discrimination of leprosy patients.
“Accelerating towards a leprosy-free world” reminds the Ministry of Health and their partners to continue mobilising the resources and to support innovative technology to overcome these challenges and ensure comprehensive services are available for people who are in need. At the same time, it is important to emphasize stigma reduction and social inclusiveness promotion which would encourage health seeking behaviours and reinforce better and earlier diagnosis of leprosy to prevent disabilities.
As the Ministry has introduced targets for Universal Health Coverage (UHC) and commitment to achieving the Sustainable Development Goals (SDGs) by 2025, WHO recommends that leprosy control services should continue to be included and integrated into the broader service delivery package. The 148 health facilities nationwide that are designated as leprosy referral centres should continue the important work on leprosy control. Let us work together to accelerate towards a leprosy-free world #ZeroDisabilities #ZeroLeprosy