Management of leprosy on the basis of the epidemiology of disabilities.

With the reduction on caseload due to the impact of multidrug therapy (MDT) in most parts of India, we believe that there is a need to understand the epidemiology of disabilities in leprosy which may not necessarily correlate with the distribution pattern of active disease. We present a methodology of data collection and verification taking the district as a unit to calculate the prevalence rate of disability as an exclusive entity in the district population, unrelated to the problems posed by the communicable component of leprosy. This study indicated that the prevalence rate of Grade II disabilities in 14 hyperendemic districts was 0.82/1000, whereas it was 0.22/1000 in low endemic districts. Limb disability data collected from three hyperendemic districts in Andhra Pradesh following task-oriented training enabled the paramedical worker to offer services to 5753 disabled patients after assessing the disability caseload per worker.