Enhanced active case-finding, identifying leprosy cases missed by recent detection campaigns in Munger District, Bihar, India

In India, some indicators of leprosy transmission are on the rise and suggest that many cases of leprosy currently go undetected. The lack of active casefinding outreach activities, aiming to find hidden cases in communities, are possible reasons for this. Lepra, an international non-governmental organisation, ran an active case-finding project in Munger District, Bihar, from 15 June to 15 December 2016, screening 85,560 people. A combined approach using Contact Surveys, Focal Surveys and Special Searches was implemented. A total of 321 new leprosy cases were found (28% Multibacillary, 47% women, 37% child cases, 59% belonging to scheduled castes, 10% to scheduled tribes, and 3% with disability and complications). The research supports evidence generated by other non-governmental organisations of a high transmission of the disease in India. Finding 303% more cases than traditional government-led detection campaigns, it shows that many cases in affected communities remain undetected in Bihar. This method was also found to be more efficient at finding vulnerable groups, child and female cases, as well as cases within scheduled castes and tribes.