重复开展消除麻风运动对当地新发现病人情况的影响

目的:观察贵州省兴义市重复开展消除麻风运动对当地新发现麻风病人的影响.方法:收集1996～2004年新发现麻风病人的有关资料进行比较分析.结果:9年共发现麻风病人166例,平均每年发现18.4例,年均发现率为2.65/10万.1999年首次开展消除麻风运动后3年,新病人中的2级畸残率和延迟期呈明显下降趋势,低于开展前3年的水平.两次开展消除麻风运动时的畸残率和平均延迟期均达较高水平,提示该地区虽两次开展消除麻风运动但麻风流行程度仍处于较高水平.结论:重复实施消除麻风运动可促进某些流行病学指标的好转,应反复多次开展.     

云南省开远市重复开展消除麻风运动效果评估

目的观察开远市两次开展消除麻风运动(LEC)对当地发现病人工作和病人临床指标的影响。方法 2003年与2008年分别开展LEC。收集2002~2008年发现病例的相关信息,对各年发现病例数、平均确诊年龄、平均延迟期、畸残率等进行比较分析。结果在观察的7年中,共发现了131例病人,平均每年发现18.7例,发现率6.23/10万。发现病人没有因为开展LEC出现数量上的明显变化,确诊平均年龄38.81岁,平均延迟期1.43年,畸残率11.45%,最大确诊平均年龄、最长平均延迟期均出现在开展LEC时。结论开远市早期发现病人工作开展较好,但重复开展LEC间隔时间过长。     

开展消除麻风运动后对当地新发现病人状况的影响

目的：分析开展消除麻风运动后对当地新发现麻风病人状况的影响。方法：通过比较麻风高流行县（市）开展消除麻风运动前、中和后一年的麻风新发现病人资料，分析新发现麻风病人各个方面情况。结果：发现所有8个县（市）在开展消除麻风运动当年发现病人数均为最高。在开展消除麻风运动后一年，防治力量强的县（市）发现病人数维持在开展消除麻风运动前一年的水平，防治力量弱的县（市）发现病人数则比开展运动前一年有减少。在开展消除运动期间发现的病人居住地离县麻风专业机构的距离最远，平均为62．8公里／人。开展消除运动期间疾病延迟期为最长，平均为42．9月，消除运动后一年发现的病人疾病平均延迟期缩短至26．5月。结论：开展消除麻风运动后在短期内不会对当地的新发现病人数产生很大的影响，但其促进了部分麻风流行病学指标好转，从而促进了当地麻风防治。     

1998-2018年陕西省麻风流行特征分析

目的：了解1998-2018年陕西省麻风流行趋势和流行特征,为开展麻风防治工作提供理论依据。方法：通过全国麻风防治管理信息系统（LEPMIS）收集陕西省1998-2018年麻风病历资料,对麻风发现率、患病率和病例基本情况进行描述性分析。结果：1998-2018年陕西省新发现麻风病例共计477例,年平均发现率为0.070/10万,年平均患病率为0.305/10万;病例平均发现年龄为46.71岁;男女比为2.46:1;多菌型（MB）399例,占83.6% ;II级畸残共148例,畸残率为31.03%;新发现病例平均延迟期为62.01个月。结论：陕西省新发麻风病例依然存在畸残比高、延迟期长和高龄化等情况,应进一步加强低流行状态下麻风的监测,减少传播和畸残的发生。     

麻风病

20031879 开展消除麻风运动后对当地新发现病人状况的影响/沈建平(中科院皮研所)…//中国麻风皮肤病杂志.-2003,19(1).-15～18 通过比较分析麻风高流行区在开展消除麻风运动(LEC)前、中和后1年的麻风新发现病人资料,发现所有8个县(市)在LEC当年发现病人数均最高,接近于LEC前一年的2倍。LEC后一年,防治力量强的地区发现病人数保持在LEC前一年的水平;防治力量较弱的地区则较LEC前一年减少(有的减少达50％)。LEC期间发现的病人距县麻风专业机构距离平均为62.8Km/人,病人疾     

江苏省1991～2002年新发现麻风病例流行病学分析

根据江苏省麻风病疫情数据库，对1991～2002年江苏省新发现麻风病例的流行病学特征进行分析。结果：1991～2002年共登记新发现麻风患者1023例，年平均发现率为0．12／10万，总的疫情趋势下降，达标前后的发现率比为2：1。45．4％的新发现患者有明确传染源，67．2％由皮肤科门诊发现。发病至确诊的平均延迟期2年，随着时间推移逐渐缩小，但近2年有所回升。92．7％的新发现病例分布在县乡农村地区。93．3％的患者通过麻防专业机构确诊，由综合医院皮肤科和基层医疗单位发现并诊断的病人数在逐年减少。江苏省麻风流行虽已遏制，仍应加强麻风队伍的建设以巩固成果。     

1999～2005年广西新发现麻风病例流行病学分析

对广西1999～2005年新发现病例进行回顾性分析，以探讨广西麻风病基本消灭后麻风的流行特征。结果：1999—2005年广西共新发现麻风病人580例，平均年发现率0．18／10万，其中13个县发现率超出了基本消灭的指标。新发病人中，型比70．34％，单皮损率11．03％；Ⅱ级畸残率15．52％；家内新发病人占新发病人的23．97％；病人发现以门诊为主。广西麻风基本消灭后，疫情又有所回升，平均延迟期较长，家庭聚簇性较明显。应继续加强麻风防治工作。     

浙江省麻风可疑症状监测系统实施效果评价

目的：评价浙江省麻风可疑症状监测系统的实施效果。方法：比较可疑症状监测系统实施前后早期发现情况、新发麻风病例畸残率和麻风病例误诊率。结果：监测系统运行后,新发现病人的平均延迟期从36.64个月缩短至17.89个月;Ⅱ级畸残率从23.15%降至12.12%;误诊率从79.27%降至25.76%。结论：建立麻风可疑症状监测系统有利于麻风病例的早期发现和降低2级畸残率。     

消除麻风运动后新病例发现情况分析

世界卫生组织1998年麻风形势报告中指出，即使在联合化疗(MDT)实施较好的地区，因各种社会文化和经济因素的影响，病人仍隐蔽在社区中，有延迟诊断治疗、发生不可逆畸残和感染家庭及社区的危险。因此，有必要在麻风高流行区开展消除麻风运动(LEC)，以尽可能地将隐蔽病人发现出来，并给予联合化疗(MDT)卫生部与WHO西太区合作，于1999年7～9     

广东省佛山市南海区1998-2018年麻风流行病学特征分析

广东省佛山市南海区1998-2018年共发现麻风患者66例,通过皮肤科门诊发现的病例占95.45%,患病率保持在<1/105的较低水平。麻风早期发现率低（36.36%）,从发病到确诊的平均延迟期为67.35个月;确诊时2级畸残率较高（39.39%）。南海区麻风病疫情整体呈低流行状态,确诊时Ⅱ级畸残率较高。     

Analysis on the detection of new leprosy cases before, during and after the year of leprosy elimination campaigns

To analyse the impact on of case finding of leprosy elimination campaigns (LECs), data on newly detected leprosy cases in a leprosy endemic area were collected before, during and after the year of LEC. The number of new leprosy cases detected during the year of LEC was significantly higher than previously. The number of newly detected cases after the year of LEC was similar to that of detected before the year of LEC in counties with persisting case finding activities. However, the number of newly detected cases after the year of LEC significantly decreased in counties without active case finding activities. The average distance from the homes of leprosy cases detected during LEC to the leprosy control unit at the count town was 62.8 km, which is farther than that of other leprosy cases detected before and after the year of LEC. The average time from disease onset to diagnosis of leprosy cases detected after the year of LEC shortened. The results also showed that carrying out LECs is unlikely to have a significant impact on the trend of case finding within a short time in local areas, but it may improve some indicators of leprosy patients and so promote leprosy control in local areas.     

开展消除麻风运动的效果评价

目的：通过开展消除麻风运动,评价其在发病人方面效果。方法：防治机构在当地政府支持下举办县级培训班和工作会议。各乡镇负责人和乡镇卫生院院长、防疫医生参加工作会议和培训班,同时通过媒介向公众开展健康教育运动。在运动中乡村医生和群众向医疗机构报告麻风人可颖线索,然后由麻风专家组成的医疗队确诊。结果：运动中覆盖９９个乡、镇的１４１１个行政村共计１３５万人口,上报１７３例麻风可疑线索,共确诊４１例麻风,其中多菌型３２例,少菌型９例,查菌阳性者２４例;２级畸残者１６例。永顺县、桑植县和崇义县、上犹县在运动中发现的病人数分别占各县全年发现病人总数的５６．３％,７７．８％和９０％。结论：短时间内发现许多病人说明消除麻风运动可有效地发现隐藏在社区内的病人。消除麻风运动还是对公众一次很好的麻风健康教育,促进了当地麻风的基本消灭。     

Characteristics and treatment outcomes of leprosy patients detected during a leprosy elimination campaign in Mozambique compared with routinely detected patients

The objective of this study is to assess whether the case-finding method is a determinant for diagnostic characteristics and treatment outcome of newly diagnosed leprosy patients in Northern Mozambique. This is a retrospective cohort study of 3202 patients on the differences between entrance characteristics and treatment outcome in self-reporting patients and patients detected during a leprosy elimination campaign (LEC) in 1999 in Northern Mozambique. As a consequence of LEC activities, 3 times more patients were found compared with the same period 1 year earlier. After the LEC, case detection remained higher in the years 2000-2002 compared with the years preceding the LEC. More young (<15 years) paucibacillary (PB) cases were diagnosed during LEC activities with, surprisingly, equal percentage of disability grades. No gender imbalance was found in diagnosed LEC patients contrary to self-reporting patient groups. Comparing patients detected during a LEC in 1999 with the passive group of 1998 and 1999 showed a slight but statistically significant better treatment result for the passive group. The classification of leprosy (in favour of PB) and age (in favour of older age groups) were also determinants for favourable treatment outcomes. Volunteers had a significantly better result of treatment compared with trained nurses and regardless of detection method. LEC proved to be a useful addition to the National Leprosy and Tuberculosis Programme in Northern Mozambique. As a result, many new cases were diagnosed and put on treatment and their treatment results were very satisfactory. LEC had a lasting impact on case finding. Volunteers make a valuable contribution to leprosy control in Mozambique because they have consistently better treatment results compared with nurses.     

A comparison of Rapid Village Survey and Leprosy Elimination Campaign,detection methods in two districts of East Java,Indonesia, 1997/1998 and 1999/2000

A Rapid Village Survey (RVS) was planned to estimate the extent of the leprosy problem in two well documented endemic districts of East Java, Indonesia. Furthermore, the aim was to investigate the efficacy of the routine programme in detecting new and early cases, as well as the feasibility of RVS in detecting disabled people affected by leprosy in the community. A random sample survey (RVS: a simple method compared to a Population Sample) was used to determine the extent of the leprosy problem. In addition, a Leprosy Elimination Campaign (LEC), was used particularly to detect new and backlog cases in the community. Both RVS and LEC involve a health education campaign followed by the examination of persons voluntarily reporting. Routine programme case finding, involving passive case finding and contact examinations, was also carried out. The RVS prevalence rate of 12 per 10,000 was more than twice the known prevalence rate of 5 per 10,000. The LEC prevalence rate was less than the rate found by RVS, but was within the RVS confidence interval. During the RVS, many children with leprosy were detected, and 10% of all RVS new cases already had disability grade II. The population disability grade II rate due to leprosy was 9 per 10,000. Despite the fact that an active leprosy control programme had been carried out in the surveyed endemic area over a period of many years, the actual prevalence rate found was more than twice the known prevalence. Many children were found during the RVS, thus indicating continuing widespread transmission. In general, it seems that there is still a serious delay in detecting new cases under the routine programme. Consequently, there are substantial numbers of persons affected by leprosy in those districts in need of rehabilitation.     

Trends in case detection influenced by leprosy elimination campaigns in certain areas of China

LECs were carried out from 1998 to 2000 in eight counties of west China. The number of cases detected during the year of LECs was much higher than that detected by routine methods before the year of the LEC. However, the annual number of cases detected during the year after the LEC showed different patterns. One pattern is that the number of new cases detected in the year after the LEC declined to the level similar to that before the year of the LEC. The second pattern is that the number of new cases detected in the year after the LEC declined steeply to less than that detected before the year of the LEC. Following peak case-detection during the year of the LEC, a gradual decrease in the number of new cases was observed in the subsequent years. The repeat LEC brought a weakly rebounding peak case-detection during the year following the first LEC carried out 3 years earlier. The operational, epidemiological and technical factors influencing the trends of case-detection during the LECs are discussed.     

Case detection, gender and disability in leprosy in Bangladesh: a trend analysis.

A trend analysis is presented of all newly detected leprosy cases over an 18-year period (1979-1996) in a highly leprosy endemic area of Bangladesh. A total of 23,678 new cases were registered, with an average of 860 new cases per year in the first 12 years, and increasing to around 3000 in 1996. The male:female (M:F) ratio decreased from 2.3 to 1.4. The proportions of newly detected cases with MB leprosy and of newly detected cases with any disability decreased over time. These reductions were more marked in the higher age groups of both sexes. The reduction in disability was primarily attributable to a decline in grade 2 disability. New case detection rates (NCDR) of all leprosy patients per 10,000 general population increased for males from 3 to 6; and for females from 1 to 4, while the NCDR of MB leprosy decreased in males from 1.4 to 0.6, and in females fluctuated around 0.45. The NCDRs of leprosy patients with disabilities showed an initial decrease in the first period, especially in males, but later showed an increase. The NCDR of males with disability was about twice as high as that of females. Finally, female NCDRs in the ages between 15 and 30 were low by comparison with the male NCDRs at the same time. This may be due to the sociocultural characteristics of the Bangladeshi society, with gender differences in exposure, health seeking behaviour and opportunities for case detection. Operational changes in the control programme have contributed to the changed profile of newly detected cases. This study shows that the application of general population statistics is essential for understanding the dynamics in leprosy control programmes under changing operational conditions. Combining case detection figures with such statistics helps to identify population groups that are possibly not benefiting sufficiently from the services provided, and to clarify the dynamics in control programmes and the future trends and programme requirements.     

Capture-recapture method to assess the prevalence of disabled leprosy patients.

The capture-recapture technique was applied in estimating the prevalence of disabled leprosy patients in four States in Northern Nigeria. A two-sample capture-recapture method, using data from hospital admissions during 1997 and 1998 in three leprosy referral hospitals, and from a sample survey on leprosy patients with disabilities in the clinics in 1999. In the sample, 1395 (ex) leprosy patients were found, 393 with a disability. Of these 393 patients, 47 had been admitted during 1997 and 1998 to one of three leprosy referral hospitals. In these hospitals, 151 individuals from the 24 study Local Government Areas (LGA) in four states of Northern Nigeria were admitted in 1997 and 1998. Using the Peterson estimator, we calculated the number of unknown disabled leprosy patients in the studied LGAs to be 1262 (95% confidence interval 991-1533). This was nearly four times greater than the field reported figure. The capture-recapture method can be applied in a leprosy care programme. Limitations of the method are the completeness of reporting after invitation in the field, as well as the probable biased sample of leprosy patients admitted to hospital. Our finding implies that relying on patients to report for prevention of disabilities and rehabilitation to the clinics, causes the real size of the problem to be underestimated by a factor of 3-4. We recommend the use of a special 'care' register for disabled leprosy patients to better address their needs for prevention of disabilities and rehabilitation.