Leprosy control: the rationale of integration

After considering the situation and the perspectives of integration and the drawbacks that a vertical approach can represent for leprosy control, the author proposes the framework of control programmes as a systemic model for comprehensive health care. The structure that health services in developing countries are adopting in order to implement PHC allows for an horizontal integration of specific activities; conversely, activities which have already proved their value for leprosy control can easily enlarge their scope and include other prevalent conditions. Integration leads to an improvement in patients' and health workers' attitudes; provided that the necessary supervision is guaranteed, integration is feasible and warrants more effective patients' care and a better exploitation of resources in order to reduce the specific risk in the community.     

Leprosy XII. T-Cell Subsets in Lepromatous Leprosy

ABSTRACT: The authors quantitated T-rosette-forming cell (TRFC) and T-cell subsets (T_μ, T_γ) in the peripheral blood of twenty patients with lepromatous leprosy. The results obtained in their studies are as follows: (1) They reconfirmed the low levels of TRFC in patients with lepromatous type of leprosy; (2) T-cell subsets, both T_μ (helper) and T_γ (suppressor) cells, showed lower levels in all patients with lepromatous leprosy than mean values of normal healthy controls; (3) The degree of decreased levels of T_μ cells (96%) was more severe than other parameters TRFC (70%) and T_γ cells (47%) in all patients with lepromatous leprosy; and (4) it may be concluded that the alteration of the T-cell subset, T_μ-cells, reflects a more fundamental abnormality than TRFC aberration in demonstrating the impairment of cell-mediated immunity in patients with lepromatous leprosy.