Antileprosy measures in Bombay, India: an analysis of 10 years' work

Leprosy control measures adopted in Bombay consist of health education, case-detection, and treatment, and are carried out mainly by the Acworth Leprosy Hospital and its subsidiary, the Greater Bombay Leprosy Control Scheme. Although the data collected on different aspects of leprosy during the 10-year period 1963-72 are hospital-based and retrospective, their analysis provides a useful indicator of the possible situation in the field. Health education is provided by medical social workers, field staff, and physicians, and the significance of this activity in relation to early detection of leprosy is analysed. It is shown, however, that case-holding is a more urgent priority than case-detection. Trials have confirmed the effectiveness of chemoprophylaxis with dapsone for contacts of infectious index cases in crowded households. Comparison of annual expenditure per outpatient in leprosy clinics with that for inpatients in a leprosy hospital demonstrates greater cost-effectiveness of outpatient treatment. Some practical recommendations are made for leprosy control.