02745nas a2200373   4500000000100000008004100001260001300042653001000055653000900065653003800074653001100112653002100123653001100144653001200155653000900167653001900176653001500195653001700210100001700227700001300244700001100257700001400268700001500282700001500297700001800312700001300330245007200343856005100415300001100466490000700477050003200484520184100516022001402357       2002                            d  c2002 Dec10aAdult10aAged10aCommunity-Institutional Relations10aFemale10aHealth Promotion10aHumans10aleprosy10aMale10aMass Screening10aPrevalence10aSouth Africa1 aDurrheim D N1 aFourie A1 aBalt E1 aLe Roux M1 aHarris B N1 aMatebula M1 aDe Villiers M1 aSpeare R00aLeprosy in Mpumalanga Province, South Africa--eliminated or hidden?  uhttps://leprosyreview.org/article/73/4/32-6333  a326-330 v73  aInfolep Library - available3 a<p>In South Africa, leprosy has been a notifiable condition since 1921. Although the WHO elimination target of less than one case per 10,000 population has been achieved at country level, the distribution of leprosy in the country is distinctly heterogeneous, with a prominent 'leprosy belt' of greater prevalence stretching across Mpumalanga Province into northern Kwa-Zulu Natal. The highest prevalence in this 'belt' has historically been in Ermelo District. Recent trends of few newly detected leprosy patients in this district raised concerns that health system changes may have resulted in failure to detect leprosy cases. Thus a large-scale community awareness campaign was conducted followed by an intensively advertised screening programme of 3-month duration at schools and central gathering points in villages and farms from 1 June to 31 August 2000. One thousand one hundred and seventy-seven people presented for clinical screening at designated points, while 790 scholars were screened at schools and an additional 1433 people were screened at their homes by the field team. Forty-four people with skin or nervous system lesions compatible with leprosy were referred for specialized assessment and biopsy where indicated. Four new leprosy patients were diagnosed, including an elderly lady with pronounced disability. Two of these patients had prior contact with the health service due to dermatological manifestations of leprosy without diagnosis being made. All patients provided a history of close prolonged contact with known leprosy patients. Ongoing intense tracing and follow-up of close contacts of proven leprosy cases may be a more efficient method of detecting leprosy cases in areas with relatively stable populations that have accomplished 'leprosy elimination', than resource intensive community surveys.</p>  a0305-7518