Remaining Challenges to Further Reduce the Leprosy Burden in Rajasthan

Leprosy is known to affect mankind since the pre -historic times and continues to affect humans even in the twentieth century. A written reference to the disease is mentioned in the ancient Atharvaveda composed before the first millennium BC.' It is a chronic, mildly infectious disease (much lesser than tuberculosis), caused by Mycobacterium leprae and affects mainly the skin and the peripheral nerves. Although the other organs are also affected in the disease2 the main signs and symptoms related to the disease are due to affection of these two organs of the body. As a result there is impaired to varying degree of loss of sensation in the hands, feet and eyes. There may be some disability also due to involvement and paralysis of the motor fibres as well. These parts of the body, if not properly cared for, lead to repeated injuries in these insensitive paralyzed parts. These may result in disfigurement, which immensely contributes to the fear and stigma towards the disease. The best way of prevention and cure of the disease at present is by early detection and treatment with Multi Drug Therapy (MDT). India achieved the elimination target of the disease in December 2005 at the National level. At the sub -National and State level some pockets do remain which report a prevalence of more than 1/10,000 population.m While Rajasthan is a low endemic State, no such pockets of endemicity have been reported from the State. We still need to be careful and vigilant, so that the disease is properly contained and even finally eradicated. The disease has been integrated with the general health services and the data being discussed is as reported to the National Leprosy Eradication Programme (NLEP) by the State Health system.