Leprosy control in Zambia.

Leprosy was a serious public health problem in Zambia until recently, with over 16,000 cases in 1982. Since then leprosy patients in the country have been put under multidrug therapy (MDT), as recommended by WHO, with support from the Sasakawa Memorial Health Foundation. Leprosy control in Zambia is combined with tuberculosis control and integrated within general health services. By 1990 52 districts (93%) had MDT, with an overall coverage of about 70% of all patients. As a result the number of registered cases has come down steadily from 16,642 in 1982 to 3,663 in 1989. Similarly, the number of new cases detected has been reduced from 1,010 cases in 1982 to 577 in 1989. On the whole the programme has gained significant momentum, although it is too early to expect a complete eradication of the disease in the near future, given the continued low level of observed new cases. Further, the implementation of MDT still lags behind the projected targets so that the potential of MDT is not being fully utilized. In addition, the problem of rehabilitation of disabled patients needs special attention. A subprogramme aimed at reducing disability through community participation is being developed within the framework of primary health care.