Leprosy in Colombia: post elimination stage?

Leprosy in Colombia is not considering as a public health problem since a prevalence rate less than 1/10000 was achieved more than ten years ago. Nevertheless, reports of 2012 from 11 of 27 departments (48%) showed incidence rates from 0.12 to 4.73 cases per 100000 inhabitants. The Ministry of Health and the National Institute of Health direct and organize the National Leprosy Program (NLP), which plan the activities for prevention, surveillance, and control at national level. The operational activities are delegated to the regional levels (municipalities, districts, departments) however in many areas poor hospital infrastructure, high costs, lack of health personnel trained, difficult access to the health services are some of the barriers that impede the development and access to the activities that the NLP publishes in guides. The above mentioned facts have as consequence late case detection with 30% of disability rates (grade 1 and 2) at the time of diagnosis. Also, there is not awareness in general population neither in health professionals about the existence of leprosy cases in Colombia. This is a review of the situation of leprosy in Colombia, taking into account not only statistical data, but also some aspects that influence late diagnosis and disability found in patients at the time of diagnosis. In this review may appear author's personal perceptions that may differ from others.