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Indian Journal of Community Medicine

Record Based Evaluation of National Leprosy Eradication Programme in Jamnagar District

Author(s): S Yadav

Vol. 32, No. 1 (2007-01 - 2007-03)


Background: With a view to eliminate leprosy, Government launched National Leprosy Eradication Programme in 1983. Modified Leprosy Elimination Campaigns further helped in case detection. Objective: To evaluate the impact of National Leprosy Eradication Programme in Jamnagar district. Methods: A retrospective record based study was conducted in Urban Leprosy Centre of Jamnagar district. Prevalence rate, New case detection rate, Percentage of cases released from treatment, Proportion of multibacillary (MB) cases among new cases, Proportion of grade II disability among new cases and Proportion of child cases among new cases were evaluated. Results: Analysis of records of ten years indicated a decrease in prevalence rate of leprosy. Over the years a declining trend in grade II disability among new cases was noted. There was an increase in percentage of patients being released from treatment. Case detection rate was increasing steadily from year 1992 to1998. Analysis of data relating to proportion of cases among children did not show a consistency in trend. Conclusion: The national leprosy eradication programme has a favorable impact towards elimination of leprosy in the district of Jamnagar.

Keywords: Leprosy, Evaluation

Leprosy is disease known since antiquity. Sushruta samhitha mentioned it in 1600 B.C. as arun kusht. The disease is riddled with so many myths and carries grave social stigma and ostracism which compels the patients to hide the disease resulting in manifestation of deformities. The national leprosy eradication programme was launched in the year 1983 with the objective to eliminate leprosy1 (reducing prevalence rate to less than one case per 10,000 population). Introduction of multidrug therapy helped in curing the patients. Introduction of modified leprosy elimination campaigns further helped in identifying the cases hidden in community and bringing them under treatment. Prevalence rate in India which was 5.76 per 10,000 in the year 1981 has been brought down to 1.3 cases per 10,000 population (March 2005). Gujarat state has achieved elimination level (Prevalence rate of 0.95 per 10,000 population in year 2004)2. The goal of national health policy was elimination of leprosy by 20053. A study was conducted to evaluate the impact of national leprosy eradication programme in Jamnagar district of Gujarat.

Material and Methods

A retrospective analysis of the data of ten years (1992 to 2001) obtained from Urban Leprosy Centre was carried out. The indicators used are4: Prevalence rate per l0000 population, new case detection rate per 100000, percent released from treatment, proportion of multibacllarry (MB) cases among new cases, Proportion (%) of “grade II disability among new cases”. Proportion (%) of “child cases among new cases”.. Grade II disability is visible deformity or damage present in hands and feet and in case of eyes it is severe visual impairment (vision worse than 6/60, inability to count fingers at 6m), lagophthalmos, iridocyclitis, and corneal opacities5.


The prevalence rate of 1.84 per 10,000 population in the year 1992 decreased to 0.34 per 10,000 population in the year 2001. NCDR was 1.28 per 10,000 population in the year 1992 which increased to 1.74 in the year 1998 and then there was decrease in no. of new cases in the year 1999 followed by increase in the year 2000 and then decrease in year 2001 to 0.65 per 10,000 population. (Table 1).

Table 1: Prevalence Rate and New Case Detection Rate of Leprosy in Jamnagar District.

Year Mid year
No. of
Cases at
End of Year
New Cases
the Year
Rate per
New Case
1992 16,08,987 297 206 1.84 1.28
1993 16,43,059 243 216 1.47 1.31
1994 16,77,131 246 225 1.46 1.34
1995 17,11,203 182 168 1.06 0.98
1996 17,45,275 195 231 1.11 1.32
1997 17,79,347 203 238 1.14 1.33
1998 18,13,419 242 316 1.30 1.74
1999 18,47,491 101 143 0.54 0.77
2000 18,81,563 136 226 0.72 1.20
2001 19,15,625 67 125 0.34 0.65

During the year 1992, 39.77% cases were released from treatment and there on every year cases released from treatment went on rising indicating adequate coverage of patients with treatment. Cases released from treatment were 73.56% cases in the year 2001. (Table 2 and Graph 2).

Table 2: Release From Treatment Cases of Leprosy

Year Total
Release From
During Year
1992 533 212 39.77
1993 513 248 48.34
1994 468 213 45.51
1995 414 228. 55.01
1996 413 199 48.18
1997 433 225 51.96
1998 519 271 52.21
1999 385 274 71.16
2000 327 187 57.18
2001 261 192 + 73.56
*Total cases = No. of existing cases at the end of previous year + New cases detected during the given year. In the year 1992, 38.30% were MB among new cases of leprosy which increased to 53.60% in the year 2001 (Table 3). Cases with grade II disability were 6.7% in the year 1992 which decreased to 1.6% in the year 2001 (Table 3). There were 9.2% child cases in the year 1992, 10.2% in the year 1994, 12.6% in the year 1997, 13.2% in the year 1999, and there is decrease in percentage of child cases which came down to 9.2% in the year 2000 and 8% in the year 2001 (Table 3).

Table 3: MB Cases, Cases With Grade II Disability and Child cases Among New Cases of Leprosy

Year No.of
New Cases
MB Cases
New Cases
Cases With II
Disabilty among
New Cases
Child Cases
New Cases
No. % No. % No. %
1992 206 79 38.03 14 6.7 19 9.2
1993 216 93 43.05 13 10.6 14 6.4
1994 225 84 37.33 16 7.4 23 10.2
1995 168 62 36.90 8 4.7 8 4.7
1996 231 82 35.49 11 4.7 14 6.0
1997 238 86 36.13 10 4.2 30 12.6
1998 316 174 55.06 19 6.01 25 7.9
1999 143 81 56.64 3 2.09 9 13.2
2400 226 115 50.88 6 2.6 21 9.2
2001 125 67 53.60 2 1.6 10 8.0


Our study revealed a declining trend of prevalence rate over the ten years under study similar to a decline from 7.8 to 0.56/10000 in Himachal Pradesh between1991 to 20006, and in Gujarat from 21.1 per 10,000 population in year 1984 to 0.95 per 10,000 population October 20042.

It was observed that NCDR was increasing from the year 1992 to the year 1998 followed by a decline. It reflects the intensification of programme activities and the effect of modified leprosy elimination campaign (MLEC) carried out in the year 1997-1998. The decline NCDR may be due to coverage of MB cases with MDT and thus decline in infection load in the community. Similar observations were found by Mahajan et al6, who also noted a steadily increasing trend in the annual detection of new cases of leprosy.

There is consistent rise over the years in cases released from treatment showing that programme is working well and the patients are being cured through complete and regular course of treatment. Proportion of multibacillary cases among newly detected cases was between 30 to 40% from the years 1992 to 1997 and there was rise to about 50 to 55% till 2001 which may be due to changed classification of leprosy based on skin lesion (positive skin smear or patients with more than five skin lessions).

Over the year a decline in cases with grade II disability was noted. It reflects that under NLEP the cases are detected early and are given timely tratment. It also reflects better awarencess creation regarding leprosy amongst the community. Halder et al in their study also found reduced deformity rate7. Percentage of children among new cases did not show a consistent trend over the years. It was seen that percentage of children among new cases was ranging between 4.7 to 13.2%. High prevalence of childhood leprosy is a strong evidence of active infection of leprosy in the community. Peat et al in their study found data relating to child rates were difficult to interpret8. Based on the observation and analysis of indicators it is concluded that the NLEP in the district of Jamnagar is making a favorable impact on the problem of leprosy and the elimination of level of leprosy has been achieved which has been brought down to 0.38 per 10,000 population.


  1. Kishore J. National Health Programmes of India. 4th edition. New Delhi, Century Publications, 2000; 132-133.
  2. Leprosy Training Module for Medical Officers. State Leprosy Cell, Commissionerate of Health, Medical Services and Med. Ed. (H), Gandhinagar, Gujarat; 4-5.
  3. Park K. Park’s Textbook of Preventive and Social Medicine. 17th edition. Jabalpur, M/s Banarsidas Bhanot Publishers, 2002.
  4. Kulkarni A. P, Baride J.P. Textbook of Community Medicine. 1st edition. Mumbai, Vora Medical Publications, 1998.
  5. WHO. A guide to eliminating leprosy as a public health problem. 2nd edition. 1997. Page no. 83.
  6. Mahajan V K, Sharma N L, Rana P, Sood N. Trends in detection of new leprosy cases at two centres in Himachal Pradesh, India; a ten year study. Indian J Lepr, 2003; 75: 17-24.
  7. Halder A, Mishra R N, Halder S, Mahato L, Saha A K. Impact of Modified Leprosy Elimination Campaign in a MDT pilot project district of India. Indian J Public Health, 2001; 45:88-92.
  8. Peat M, Brolin L, Ganapati R, McDougall A C, Revenkar C R, Watson J W. An evaluation of the contribution of the Swedish International Development Authority (SIDA) to leprosy control in India based on the implementation of multi-drug therapy (MDT) 1981 – 1993. Indian J Lepr, 1995; 67:447-65.

Deptt. of Community Medicine
H.P. Shah Medical College Jam Nagar, Gujarat-361008
E-mail: [email protected]
Received: 3-3-05

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