General health education as the main approach to leprosy control, Dichpalli, India

Abstract

Leprosy control in an integrated Community Health Project (CHP) and in a conventional Survey, Education, Treatment (SET) programme are compared over a period of 5 years. In the CHP priority was given to intensive, continuous health education on various subjects, including leprosy, by mainly illiterate Village Health Workers (VHW), 1 per 1,000 population. In the SET programme the emphasis was on house-to-house survey for leprosy patients only by well educated paramedical workers, 1 per 20,000 population. Case finding in the SET was better than in the CHP. However, while the number of few patients in the SET remained fairly constant over the years, it more than doubled in the CHP. Case holding in the SET gradually increased to 64% of the registered patients receiving regular treatment, while in the CHP the corresponding figure rose to 90%. The integrated approach with the emphasis on health education seems to lead to a better quality contact between the VHW and the leprosy patient. Supervised combined therapy of all patients, tuberculoid and lepromatous, in accordance with the latest principles is now a distinct possibility.