India is world’s leprosy capital, despite its ‘elimination’ in 2005

India is the leprosy capital of the world, accounting for 60 per cent of the 2,12,000 people detected with leprosy globally in 2015, according to the World Health Organisation (WHO), although leprosy is officially eliminated in India.

As per WHO norms, leprosy is eliminated if the prevalence of the disease is less than one case per 10,000 population. And India has achieved statistical elimination of leprosy with a national prevalence rate of 0.96 in 2005.

The prevalence rate declined to 0.66 in 2015-16, but a complete eradication of the disease is a long way off.

However, leprosy cases with severe deformities have increased by 50 per cent in the past six years, indicating that many cases of the curable disease are being detected late.

Figures released by the government-run National Leprosy Eradication Programme show that 5,851 leprosy cases with 'grade 2' disabilities were detected between 2015 and 2016 compared to 3,865 in 2011-2012.

Grade 2 disabilities refer to the presence of visible and often permanent deformities caused by damage to the patient's 'peripheral nervous system', which excludes nerves in the brain and the spinal cord. These deformities, for example, include muscle damage in the fingers, toes and visual impairment, which affect basic day-to-day activities such as holding objects, wearing slippers, cooking and typing.
 
This rising trend of late diagnosis is a cause for concern, especially after the government had declared leprosy had been eliminated from India in 2005.

''A patient with leprosy develops severe disabilities only if the condition is left untreated for at least two years from the time of infection,'' says a report quoting Dr Vivek Pai of the Bombay Leprosy Project, a non-governmental organisation, which sees almost 40 referrals in a month. ''Managing a leprosy case once the deformity has set in is certainly not easy. The damage sometimes is irreversible.''

Dr Poonam Khetrapal Singh, World Health Organisation (WHO) regional director for South-East Asia, in a statement on World Leprosy Day - January 29 - said, ''Disabilities do not occur overnight, but happen after a prolonged period of undiagnosed disease. Early detection is key to achieving this target, alongside scaling up interventions to prevent leprosy transmission.''

Meanwhile, a massive door-to-door survey, covering 360 million people, conducted by the government in September-October 2016 reported 31,666 new cases, including 3,755 among children.

Experts, however, say that leprosy cases could be underreported owing to major shortfalls in the implementation of screening methodologies.

Lack of awareness and fear of social stigma, too, prevent people from reporting their condition, say doctors.

Doctors have suggested mandatory physical screening of people during surveys to detect cases early and prevent disabilities.
 
Leprosy is a chronic infectious disease which affect the skin, peripheral nerves and mucus membrane of the upper respiratory tract.

The disease could be contacted through droplet infection from coughing, sneezing and nasal discharge.

The symptoms and signs of the disease are light or reddish patches on the skin, loss of feeling in the skin, numbness or tingling sensation in the hand and feet.