03512nas a2200397   4500000000100000008004100001260001300042653001500055653001000070653000900080653002200089653001000111653003000121653001100151653001100162653001000173653002300183653001200206653000900218653001600227653002800243653001500271653003100286100001600317700001500333700001200348700001200360700001200372245014200384856005900526300000900585490000700594050003200601520246700633022001403100       2001                            d  c2001 Mar10aAdolescent10aAdult10aAged10aAged, 80 and over10aChild10aDrug Therapy, Combination10aFemale10aHumans10aIndia10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged10aPopulation Surveillance10aRecurrence10aSurveys and Questionnaires1 aManjunath R1 aKamath K N1 aPai G S1 aPinto J1 aVinod V00aModified Active Surveillance System (MASS); a novel clinicopathological evaluation of PB leprosy patients after RFT, in Mangalore, India.  uhttp://leprev.ilsl.br/pdfs/2001/v72n1/pdf/v72n1a08.pdf  a50-60 v72  aInfolep Library - available3 a<p>The current recommendations for leprosy control programmes include stopping active surveillance in view of the very low relapse rates and a phased integration of leprosy services with the general health services. Passive surveillance may not be adequate, more so because of the introduction of newer, shorter drug regimens. This study is an effort to evolve a modified active surveillance, which is cost-effective, simple and also a novel substitute for the increased workload caused by the dwindling number of PMWS. One thousand one hundred RFT-PB leprosy patients were recalled for a review under the Modified Active Surveillance System (MASS), carried out over two phases. Patients were divided into groups as per the mode of response to the mailed postcards; Responders (patients who reported to the OPD in person), Untraceables (patients whose postcards returned back) and non-responders (patients who did not report of the OPD after receiving the mail). At the end of phase I, we had 120 Responders, 480 Untraceables and 500 Non-responders. In phase II, which began 2 months later, the 500 non-responders were dispatched reminders. In this phase, there were 31 responders, 60 untraceables and 409 non-responders. Thus, at the completion of phases I and II, there were 151 responders, 540 untraceables and 409 non-responders. Of the 151 patients examined, 71 had no complaints (category 1), 41 had fresh leprosy-related complaints (category IIA), 14 had fresh leprosy-unrelated complaints (category IIB) and 25 had persistence of old complaints (category III). Cumulative PYR of the 151 patients was 1155.42. Forty-one patients had fresh leprosy-related complaints. Skin biopsy was done in the 17 patients with fresh skin patches, of whom four showed histopathological evidence of relapse. Relapse rate in our study was 0.35/100 PYR. Mean duration after RFT at relapse was 4.9 years. Our scepticism towards passive surveillance systems is justified by these 41 patients with fresh leprosy-related complaints, who voluntarily reported only after receiving the postcards. We recommend the introduction of a phase III, wherein the services of PMWs may be used to contact the 409 patients who remained unresponsive at the completion of phases I and II. We also recommend the introduction of a universal format for recording addresses of all new patients, which would be of immense help in patient retrieval in all such surveillance systems in the future.</p>  a0305-7518