The estimated number of leprosy patients in the country is 4 million. This accounts for one-third of the global leprosy load. The leprosy rate ranges between 10 per cent to 25 percent in different areas. The deformity rate is approximately 10 to 15 percent. About 15 percent total children. The disease endemicity varies widely in the country. The prevalence rate exceeds 5 per 1000 in 196 districts out of 445 districts in the country. Nearly 435 million people live in these 196 endemic districts. At the end of October 1990, there were a total of 2.5 million registered cases in the country which include 0.47million new cases detected during the year 1989-90. (Source:Annual Report 1991-92, Ministry of Health and Family Welfare, Government of India, 1992).
Though the disease is found throughout the country, it is not equally distributed. There is wide variation in the prevalence. Even in the low endemic areas there are pockets of high endemicity.
The areas of high prevalence are now found mainly in the south-eastern part of the country which includes the States of Tamil Nadu, Orissa, Bihar, Pondicherry and Andaman and Nicobar Islands.
The areas of moderate prevalence are found mostly in the central and south-western part, eastern part of the country and the himalayan foot hills. The areas of low prevalence are found mainly in the north-western parts of the country.
Activities : The main activities under NLEP include early detection of cases by house to house surveys, school surveys, slum surveys, and to bring all the detected cases under regular treatment as near to their house as possible. Emphasis is given on education of the patients, their families and the community on facts about leprosy and its curability etc.
Active involvement of the non-governmental organisations is encouraged in all these programme activities. Basic training is provided to vertical staff and orientation training is provided to the general health care staff.
Infrastructure : The magnitude of the case load and the high endemicity in the country needed the deployment of especially trained vertical staff for rendering leprosy services. In endemic areas, one Leprosy Control Unit (LCU) covers 4 to 5 lakh rural population and is manned by 4 non-medical supervisors and 20 para- medical workers. The urban leprosy centre is manned by a paramedical worker who covers 50,000 urban population. At the district level, the office of the District Leprosy Officer has been set up and there are 244 such units functioning as present, 49 leprosy training centres are engaged in training of manpower required for carrying out the programme activities. Important services provided under the programme, therefore, include: case detection and treatment; health education; community participation; maintenance of records; training; monitoring; and rehabilitation and administering multidrug treatment.
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