02659nas a2200313   4500000000100000008004100001260001300042653001500055653001000070653001000080653002600090653001100116653001100127653001200138653000900150653001600159100001300175700001100188700001200199700001200211700001100223245008100234856005900315300001100374490000700385050003200392520190700424022001402331       2001                            d  c2001 Sep10aAdolescent10aAdult10aChina10aEpidemiologic Methods10aFemale10aHumans10aleprosy10aMale10aMiddle Aged1 aChen X S1 aLi W Z1 aJiang C1 aZhu C B1 aYe G Y00aStudies on mode of detection of leprosy in China during the years 1981-1998.  uhttp://leprev.ilsl.br/pdfs/2001/v72n3/pdf/v72n3a09.pdf  a302-100 v72  aInfolep Library - available3 a<p>Along with the nationwide economic reform initiated in the early 1980s and the rapid decrease of leprosy endemic after the implementation of multi-drug therapy (MDT), the leprosy programme changed from 'vertical' to 'horizontal'. An evolution in the mode of detection of leprosy cases has consequently taken place. Based on the nationwide registration of newly detected cases, the profile of patients at detection has been studied. The proportions of cases corrected significantly with calendar years in detection by dermatological clinics, contact checks, 'clue survey' and mass survey, showing a significant increase in percentage of cases detected through dermatological clinics and contact checks, and decreases through 'clue survey' and mass survey. Detection of cases through dermatological clinics and voluntary reporting have become the main modes of case-finding during 1997-1998, accounting for 37.3% and 28.6%, respectively, where contact check accounts for only 9.1%. In areas with good dermatological services, a significantly higher proportion (75.9%) of cases was detected through dermatological clinics, where voluntary reporting and 'clue survey' were the main modes of detection in endemic areas. As regards confirmation of diagnosis, the great majority of cases were confirmed by leprosy units, even though they were detected in various other situations. Only 6.5% of leprosy cases were detected and subsequently confirmed by doctors in dermatologic clinics. The present modes of detection and their relation to demographical, epidemiological, clinical factors and health services are discussed. This study emphasizes the cardinal importance of the dermatological clinics in the detection of leprosy cases in China at the present time and hence the need to strengthen the training of doctors in these clinics, while continuously encourage their involvement in leprosy control.</p>  a0305-7518