Leprosy control in the Northern Territory

An epidemic of leprosy occurred among Aboriginal people of the Top End of t he Northern Territory following its introduction towards the end of the 19t h Century. The extent of this outbreak became apparent through community su rveys conducted in the 1950s which revealed that one in 10 Aboriginal peopl e in some areas were affected by leprosy. Initial control activities were o utbreak-focused, directed at case finding and management. Case finding was by systematic community survey. Case management included appropriate rehabi litation and reconstructive surgery. Regular review of treated patients ens ured early detection of relapse and detection and treatment of sequelae. Ed ucation and full participation of Aboriginal health workers in the diagnosi s and management of cases provided local expertise at the hospital and comm unity level. The case detection rate fell from 270 per 100,000 in the Abori ginal population in 1951 to four per 100,000 in 1997. Elimination of transm ission is now the objective of the control program. Combining of the tuberc ulosis and leprosy control activities of the Territory Health Service in 19 96 resulted in increased efficiency of the mycobacterial services.