02422nas a2200301   4500000000100000008004100001260001300042653003300055653004000088653001800128653001100146653002300157653001200180653002500192653002800217653001500245653002400260653003000284100001600314700001500330245007000345856007400415300001000489490000700499050001900506520158100525022001402106       2005                            d  c2005 Mar10aCommunicable Disease Control10aDelivery of Health Care, Integrated10aGlobal health10aHumans10aLeprostatic Agents10aleprosy10aMycobacterium leprae10aPopulation Surveillance10aPrevalence10aProgram Development10aWorld Health Organization1 aLockwood DN1 aSuneetha S00aLeprosy: too complex a disease for a simple elimination paradigm.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2624210/pdf/15798849.pdf  a230-50 v83  aLOCKWOOD 2005A3 a<p>Can leprosy be eliminated? This paper considers the question against the background of the WHO programme to eliminate leprosy. In 1991 the World Health Assembly set a target of eliminating leprosy as a public health problem by 2000. Elimination was defined as reaching a prevalence of < 1 case per 10 000 people. The elimination programme has been successful in delivering highly effective antibiotic therapy worldwide. However, despite this advance, new-case detection rates remain stable in countries with the highest rates of endemic leprosy, such as Brazil and India. This suggests that infection has not been adequately controlled by antibiotics alone. Leprosy is perhaps more appropriately classed as a chronic stable disease than as an acute infectious disease responsive to elimination strategies. In many countries activities to control and treat leprosy are being integrated into the general health-care system. This reduces the stigma associated with leprosy. However, leprosy causes long-term immunological complications, disability and deformity. The health-care activities of treating and preventing disabilities need to be provided in an integrated setting. Detecting new cases and monitoring disability caused by leprosy will be a challenge. One solution is to implement long-term surveillance in selected countries with the highest rates of endemic disease so that an accurate estimate of the burden of leprosy can be determined. It is also critical that broad-based research into this challenging disease continues until the problems are truly solved.</p>  a0042-9686