02733nas a2200421   4500000000100000008004100001260001700042653003300059653003000092653001100122653001100133653001000144653002300154653001200177653000900189653001600198653002500214653002900239653001400268653001500282653001300297653001700310653002100327653003100348100001800379700002100397700001500418700001700433700001800450700001500468700001500483245009400498300001100592490000700603050003200610520165500642022001402297       2003                            d  c2003 Oct-Dec10aCommunicable Disease Control10aDrug Therapy, Combination10aFemale10aHumans10aIndia10aLeprostatic Agents10aleprosy10aMale10aMinocycline10aMycobacterium leprae10aNational Health Programs10aOfloxacin10aPrevalence10aRifampin10aRural Health10aRural Population10aSurveys and Questionnaires1 aSubramanian M1 aShowkath Ali M K1 aThorat D M1 aMuthukumar M1 aSathiskumar E1 aRamadoss C1 aAli Khan M00aLeprosy situation in endemic states of India and prospects of elimination of the disease.  a335-450 v75  aInfolep Library - available3 a<p>In India there is a dramatic fall in the prevalence rate (PR) of leprosy, but the new case-detection rate (NCDR) has not been reduced concomitantly. It is the operational efficiency of the National Leprosy Eradication Programme (NLEP) that has led to a significant reduction in the NCDR in Andhra Pradesh and Tamil Nadu. The ratio of PR to NCDR has been declining in these two states and it reveals that elimination could be reached even with the high NCDR level of 3 to 4 per 10000 population, particularly if single skin lesion (SSL) cases are discharged through single dose treatment of rifampicin, ofloxacin and minocycline (ROM). On the other hand, the significant number of cases detected in Bihar and Orissa during modified leprosy elimination campaigns (MLECs) reveals that there are lacunae in operational activities in new case-detection resulting in a large number of undetected cases in the community. Only one-third of the cases are reporting voluntarily. Awareness of leprosy is not adequate to motivate the patients to report voluntarily and complete their treatment, thus underscoring the need for relying on active case-detection so that transmission can be broken and elimination of leprosy achieved. In addition, the influence of socio-economic factors on continued occurrence of leprosy cannot be ruled out. The establishment of a sentinel surveillance system along with a computerized simplified information system to gain in-depth knowledge on the functioning of the NLEP will ensure operational efficiency. In view of this situation, the NLEP should adopt a more realistic approach towards reaching the elimination goal.</p>  a0254-9395