Leprosy Situation in P. R. China

From 1993 to 2005, the number of newly detected leprosy cases did not decrease significantly. About 1,400 -1700 new cases were detected every year. More than 50 % of newly detected cases were reported by the southwest of China, namely Yunnan, Sichuan, Guizhou, Hunan, and Tibet. The average delay time of disease among the newly cases was about 3 years. The proportion of children under 15 among newly detected cases was 2-4%.The proportion of grade two disabilities among all newly detected cases was 20%-25% in recent ten years. Proportion of MB cases with BI positive among the all new cases was about 65%.

Possible causes for persistence of leprosy in China

1. Some villages in mountain areas are difficult to access. Leprosy services can not reach to each patient and each family.

2. Most of population there belongs to minority populations who have a problem of communication on leprosy health education. (Detection delay is due to patient).

3. The local health workers lack of leprosy knowledge and skill. (Detection delay is due to health staff).

4. Most of cases are MB and they have no visible skin lesions at the early stage of disease. This makes a big difficulty of early diagnosis on leprosy.

Strategies and actions:

1. To carry out the leprosy health education campaigns, and to improve the awareness of leprosy in communities in order to shorten the patient delay.

2. To intensify training on leprosy for health workers: 1) Dermatologists working at provincial and district general hospitals; 2) Paramedical workers in the pocket areas; 3) This will make medical workers aware of leprosy and shorten the health services delay when leprosy patients first visit a doctor.

3. To intensify the case detection in leprosy pocket areas: Regular follow up of leprosy contacts and the clue survey in pocket areas for detecting early patients. This may be the best way to detect MB cases in the early stage.

4. To integrate leprosy control with General Health Services: 1) All health worker at township hospitals and village clinics will be aware of leprosy. They can refer the suspected patients to the referral center; 2) Health workers at township or village level also can conduct treatment, follow-up, POD and so on for leprosy patients.