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Leprosy elimination at sub-national level.

R E Suarez1, C Lombardi

  • 1Short-Term Consultant, Leprosy, PAHO/WHO, Brazil. suarezrg@opas.org.br

Leprosy Review
|August 2, 2000
PubMed
Summary

New strategies are crucial for countries that have achieved leprosy elimination to prevent disease re-emergence. This involves estimating true prevalence and implementing targeted post-elimination surveillance to ensure sustained control and eventual eradication.

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Area of Science:

  • Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • Leprosy elimination has been achieved by most endemic countries, yet concerns remain regarding waning political commitment and potential disease resurgence.
  • Sustaining control efforts post-elimination is critical to prevent the re-emergence of leprosy and achieve long-term eradication goals.

Purpose of the Study:

  • To review existing literature on post-elimination strategies for leprosy.
  • To propose methods for estimating true leprosy prevalence, accounting for hidden cases diagnosed late.
  • To suggest national and sub-national strategies for the post-elimination phase to interrupt transmission.

Main Methods:

  • A comprehensive literature review on leprosy post-elimination strategies was conducted.
  • A novel approach is proposed to estimate true leprosy prevalence by considering hidden prevalence derived from late diagnoses.
  • Stratification at the sub-national level, utilizing estimated true prevalence, is explored for targeted interventions.

Main Results:

  • The review highlights the need for renewed political-technical commitment even after achieving elimination goals.
  • The proposed method offers a way to identify and quantify underreported leprosy cases.
  • Stratified approaches at sub-national levels are identified as key for effective post-elimination surveillance.

Conclusions:

  • Developing robust post-elimination strategies is essential to maintain progress and prevent leprosy re-emergence.
  • Accurate estimation of true prevalence, including hidden cases, is vital for effective long-term control.
  • Sustained, targeted efforts are necessary to achieve the ultimate goal of leprosy eradication.

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