Hidden sources of infection in unapproachable areas

The population living in the hilly terrains of Panvel taluka, District Raigad of Maharashtra State was examined in a special campaign carried out during a time when the majority of the population will be stationed at the hills. Examination of 10499 persons revealed 108 leprosy cases (PR 10.3/1000) of which 72 were paucibacillary (PB) and 29 were multibacillary (MB) cases. Among the PB cases, only two had single lesion type and among the 29 MB cases, 14 were smear-positive, having BI more than 4. These untreated advanced leprosy cases, in view of their frequent migrations in order to earn their livelihood, may be responsible for transmitting the infection in the plains areas where multidrug therapy is practiced since 1990. In order to achieve early leprosy elimination, it is necessary to cover populations in difficult areas like the one mentioned by special action programmes.