Leprosy was eliminated as a public health problem in Sri Lanka in 1995. In 2001, leprosy control activities in Sri Lanka were integrated into the general health services which transferred the duties performed by the dedicated staff of the Anti-Leprosy Campaign to Dermatologists assisted by the nursing officers and other supportive staff. We investigated possible programmatic reasons for the time taken for further reduction of the Leprosy burden in Sri Lanka after eliminating it as a public health problem in 1995.
We reviewed reports and other published material to extract relevant data. Performance indicators used by the Anti Leprosy Campaign (ALC) were obtained from Annual Reports. Information on dermatologists was obtained from the Annual Health Bulletins of the Ministry of Health. A piecewise regression analysis was used to model new case detection rate on year with 2014 as the inflection point. Pearson correlation coefficients were derived to show associations.
The new case detection rate has been between 8 and 10 new cases per 100 000 population from 2000 to 2013, after which a declining trend is seen. The child cases have declined further comprising around 10% and deformities and late presentations have declined from 2015 to 2019; multibacillary cases comprised over 55% of all cases. In 1995, there were 0.06 dermatologists per 100,000 population (n = 11). When the activities of the ALC were integrated into the general health services in 2001, there were 10–15 dermatologists in the whole country; in 2014, when the case detection rate started to decline there were 0.29 dermatologists per 100 000 population (n = 61) with the number increasing since then. There was a significant negative correlation between new case detection rate and number of dermatologists per 100,000 population from 2014 to 2019 (r = (-0.903); p = 0.035) but not from 2010 to 2014 (r = 0.246; p = 0.690).
The decline in relevant indices since 2014 is likely to be due to availability of more dermatologists in the country. Eliminating leprosy as a public health problem is likely to have led to complacency; integration of the vertical programme to the general health services may have been premature without having a sufficient number of clinicians for diagnosis.
BT - BMC Health Services Research DA - 08/2026 DO - 10.1186/s12913-026-15293-5 LA - ENG M3 - Article N2 -Leprosy was eliminated as a public health problem in Sri Lanka in 1995. In 2001, leprosy control activities in Sri Lanka were integrated into the general health services which transferred the duties performed by the dedicated staff of the Anti-Leprosy Campaign to Dermatologists assisted by the nursing officers and other supportive staff. We investigated possible programmatic reasons for the time taken for further reduction of the Leprosy burden in Sri Lanka after eliminating it as a public health problem in 1995.
We reviewed reports and other published material to extract relevant data. Performance indicators used by the Anti Leprosy Campaign (ALC) were obtained from Annual Reports. Information on dermatologists was obtained from the Annual Health Bulletins of the Ministry of Health. A piecewise regression analysis was used to model new case detection rate on year with 2014 as the inflection point. Pearson correlation coefficients were derived to show associations.
The new case detection rate has been between 8 and 10 new cases per 100 000 population from 2000 to 2013, after which a declining trend is seen. The child cases have declined further comprising around 10% and deformities and late presentations have declined from 2015 to 2019; multibacillary cases comprised over 55% of all cases. In 1995, there were 0.06 dermatologists per 100,000 population (n = 11). When the activities of the ALC were integrated into the general health services in 2001, there were 10–15 dermatologists in the whole country; in 2014, when the case detection rate started to decline there were 0.29 dermatologists per 100 000 population (n = 61) with the number increasing since then. There was a significant negative correlation between new case detection rate and number of dermatologists per 100,000 population from 2014 to 2019 (r = (-0.903); p = 0.035) but not from 2010 to 2014 (r = 0.246; p = 0.690).
The decline in relevant indices since 2014 is likely to be due to availability of more dermatologists in the country. Eliminating leprosy as a public health problem is likely to have led to complacency; integration of the vertical programme to the general health services may have been premature without having a sufficient number of clinicians for diagnosis.
PB - Springer Science and Business Media LLC PY - 2026 SP - 1 EP - 26 T2 - BMC Health Services Research TI - Leprosy control in Sri Lanka after eliminating the disease as a public health problem: implications for elimination of transmission of infectious diseases UR - https://link.springer.com/content/pdf/10.1186/s12913-026-15293-5_reference.pdf SN - 1472-6963 ER -