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| Summary |
Reports the conclusions reached by an expert committee commissioned to review the global leprosy situation in 1997, assess the adequacy of current technology for eliminating the disease as a public health problem, and identify the remaining obstacles. The need to reach patients living under difficult conditions or in remote areas was identified as a major priority. The experts also reviewed the results of several recent studies in order to determine whether diagnostic tools could be simplified and treatment regimens shortened.
The opening sections describe the considerable achievements made possible by multi-drug therapy, present the latest statistics on estimated and registered cases, and provide updated information on the epidemiology of the disease, giving particular attention to questions of diagnosis, clinical classification, and case detection that can help strengthen and extend leprosy services.
Against this background, the most extensive section summarizes the state-of-the-art in the chemotherapy of leprosy. In a key achievement, the report reaches several conclusions that promise to cut the costs of leprosy control considerably, improve patient compliance, and reduce the workload for health services. The experts concluded that a single dose of a combination of rifampicin, ofloxacin and minocycline is an acceptable and cost-effective alternative regimen for the treatment of single-lesion paucibacillary leprosy. The experts further concluded that the duration of the current standard regimen for multibacillary leprosy could be shortened to 12 months.
The report also addresses the problems of drug resistance, relapse, and the management of reactions and neuritis. A section on disabilities and rehabilitation calls for a fresh strategy that can ensure a practical, community-oriented approach aimed at reaching the largest number of persons in need. The remaining sections consider what can be done to strengthen and accelerate activities aimed at reaching the remaining pockets of leprosy, and point to the continuing need for careful monitoring of the global leprosy situation. |
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