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Leprosy elimination at sub-national level.

New strategies for the countries that have already achieved the elimination goal, which includes the great majority of the endemic countries, are needed. There is current concern in these countries about the reduction in the political-technical commitment when the goal is achieved and the possibility of the re-emergence of the disease. A review of the literature on the leprosy post-elimination strategy is done. The proposal to estimate the true prevalence using hidden prevalence based on late diagnosis of the new cases is made. Suggestions are explored for strategies of the work after elimination at national level is attained such as the stratification at the first sub-national level, using estimated true prevalence. It is considered necessary to define strategies for the post-elimination phase with the aim of continuing to the long-term objective of the interruption of transmission and the consequent leprosy eradication.