Leprosy in the Comores 1981-88

The evolution of the leprosy endemic in the République Fédérale Islamique des Comores between 1981 and 1988 is described. Leprosy on Grande Comore seems to be extinct. On the island of Anjouan the yearly detection rate is 0.38 per 1,000 with a high multibacillary rate (34%). Leprosy is highly endemic in children: during the last 6 years, 30% of multibacillary and 44% of paucibacillary cases are detected in the less than 15 years age group. Detection seems to be early as illustrated by the high proportion of paucibacillary patients with a small number of skin lesions and a low proportion of patients with severe infirmity. In the detection process both patient's and doctor's delays are short. Most diagnoses are suspected by relatives or others who had the disease in the past and who referred the suspects directly to the specialised service.