Experiences from a collaborative project on the prevention of disability in leprosy patients in Shandong Province, the People's Republic of China

Shandong Province (present population 89 million) in the People's Republic of China established a leprosy control programme in 1955. Between that year and the end of 1999, allowing for death and migration, the cumulative numb er of cases registered was 53,618, including 120 cases on multiple drug the rapy (MDT) and 18,248 who had completed satisfactory courses of dapsone mon otherapy and/or MDT. Of this latter group, 9500 cases (52%) suffered from v isible disabilities (grade 2 of the WHO classification). Prevalence and inc idence rates of leprosy have decreased dramatically since 1955 and, on aver age, only 50-70 new cases are now being detected annually in the entire pro vince. Leprosy is thus no longer a public health problem, but the existence of such a large number of patients with grade 2 disabilities is clearly a matter of serious concern. This paper describes a pilot project to investig ate the potential of health personnel in the leprosy programme and the derm atology and sexually transmitted diseases services to (a) prevent deteriora tion of existing disabilities in ex-patients through self-care and (b) prev ent new neuritis in patients on MDT through early detection and the use of steroids.