02747nas a2200301   4500000000100000008004100001260001300042653003000055653002100085653001100106653001000117653002300127653001200150653001900162653002900181653001700210653001400227100002000241700001200261700002000273245007300293856005900366300001000425490000700435050003200442520195700474022001402431       1999                            d  c1999 Dec10aDrug Therapy, Combination10aHealth Promotion10aHumans10aIndia10aLeprostatic Agents10aleprosy10aMass Screening10aRegional Health Planning10aTime Factors10aWorkforce1 aVijayakumaran P1 aRao T P1 aKrishnamurthy P00aPace of leprosy elimination and support teams in Bihar state, India.  uhttp://leprev.ilsl.br/pdfs/1999/v70n4/pdf/v70n4a10.pdf  a452-80 v70  aInfolep Library - available3 a<p>Despite the extensive implementation of multiple drug therapy (MDT) in most leprosy-endemic countries world-wide since 1982, bringing about a remarkable reduction in prevalence, there are still regions at the sub-national level where the implementation of MDT remains difficult. The state of Bihar (population 86.3 million) in India is a good example of such a region. Previously rated as one of the most highly endemic states, it still contributes about 21% of the total caseload in India and about 12% of the global caseload. For various reasons, case-finding and drug treatment have lagged behind the progress made in most other states in the country and in 1996, the Damien Foundation India Trust (DFIT) volunteered technical support to increase the pace of elimination. Sixteen out of the 39 districts in the state were allocated, with a population of 41.8 million. Support teams, including a Medical Advisor and a Non-Medical Supervisor, both with over 10 years experience of leprosy work and control programmes, were provided to assist and work alongside government staff in case detection, treatment delivery, case-holding and discharge in their respective areas of operation. New case detection by intensive survey increased by 394% and total new case detection by 226% during the year 1996-1997, with similar trends in the following year. Striking improvements were also observed in MDT coverage, treatment regularity, monitoring and discharge of patients and in the training of local staff. This collaboration between a non-government agency (DFIT) and the staff of the National Leprosy Eradication Programme in 16 out of 39 districts in the State of Bihar has clearly been extremely successful. Similar approaches in the remaining districts of Bihar, and in other parts of India, where the infrastructure is available but inadequate, may contribute significantly to achieving the elimination goal at national and sub-national levels.</p>  a0305-7518