New developments in ALERT leprosy control programme and the issues of integration

ABSTRACT
Introduction of Multidrug Therapy (MDT), as recommended by the WHO in 1982, started in Shoa Administrative Region in the beginning of 1983. From the results of introduction of the new regimens in two districts in the north-eastern part of the region, it can be concluded that implementation of MDT for paucibacillary patients has proven to be successful and feasible. Implementation of MDT in Addis Ababa and two surrounding districts, which started in March 1984, gives so far very promising results. Essential requirements for successful implementation of MDT are discussed. Reasons are given for a continuously high workload, at least during the .first years after the majority of the patients have been released from chemotherapy. Integration of leprosy control with the general medical services should definitely be aimed at; however, integration should be carefully planned and timed. Implementation of MDT requires reorganization and upgrading of virtually all aspects of leprosy control. This asks for specialization as regard planning, organization and evaluation. Another aspect of integration is the combination of tuberculosis and leprosy. The leprosy control services could strengthen the tuberculosis services at the time laboratory services have been established and the initial phase of intensive treatment has been secured.