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A review of the trend in leprosy new case detection in an Indian village over 23 years.

We conducted a review of all leprosy case records maintained at Claver Social Welfare Centre, Amda, Sararikela-Kharsawan District, Jharkhand during March 2006. The centre has been doing leprosy work for the last 25 years and we focused on one village, Kudasingi, because one new patient presented recently at the clinic. The village is a group of households with people subsisting by cultivating land, (mainly landless labourers) or owning a small piece of land. The habitats are closely packed clusters and rows, built out of clay bricks and thatched with tiles or husk. The population in this village has risen from 627 to 853 persons in this period living in 192 households. Over 23 years there were 89 new patients diagnosed in this study village, of whom 16 were children and 48% were male. The trend over the 23 years is presented in Figure 1, the peaks in case detection represent periods of intensified case finding and leprosy elimination campaigns. Seventy patients completed the prescribed drug regimen, 19 patients left the control area or died, and 2 patients treated 10 years back have relapsed. Four patients who completed treatment had residual Grade 2 disability; they had presented late with disability at detection. The trend in new leprosy case detection continues to be stable and persistent in this village with peaks representing operational activities. This simple review of leprosy trends in a small village in India gives a clear message of the continuing need for surveillance and sustained quality leprosy care for patients at all stages.