Under-reporting of leprosy cases impedes Kerala’s health goals

A representative of the Kerala Private Hospitals Association denied that there is large-scale under-reporting.
Image used for representational purpose.(Express Illustration)

THIRUVANANTHAPURAM: Notwithstanding the target of eradicating leprosy by 2025, the disease continues to be a major challenge for the health department due to the under-reporting of cases. The number of new cases has declined over the years from 705 reported in 2018-19. More recently, the state reported around 500 new cases annually, but the actual figure is likely to be at least 50% higher as health experts suspect several unreported cases in private hospitals, which are keen to protect patient confidentiality.

“Though leprosy comes under notifiable diseases, we have found that some private hospitals fail to share patient numbers with the department. We are focussing on identifying the unreported cases and facilitating treatment to meet the target of zero transmission by 2030,” an officer with the health department said.

“We can hold private hospitals accountable under the Public Health Act. There is also a concern that people seeking to suppress the infection in the family look for unscientific treatment methods,” he added.

Having previously been declared leprosy-free in 2005, the state saw a resurgence of cases from 2016. This was followed by the launch of Ashwamedham, a leprosy detection campaign involving door-to-door surveys, in December 2018.

Dr Purushothaman Kuzhikkathukandiyil, professor of paediatrics at Malappuram MES Medical College & Hospital, said the stigma associated with the disease is a concern despite awareness campaigns. “There could be under-reporting in the case of leprosy due to the stigma. In the case of tuberculosis, also a notifiable disease, the reporting mechanism is much better,” he said.

A representative of the Kerala Private Hospitals Association denied that there is large-scale under-reporting. Even if there are some cases, only a few private hospitals could be involved, he said.

Leprosy is an airborne contagion that is transmitted by the bacteria Mycobacterium leprae. Leprosy causes severe, disfiguring skin sores and nerve damage in various parts of the body. However, the disease is completely treatable and curable by various medicinal treatments for 6 to 12 months.

The department’s campaigns focus on infection among children as they are more susceptible to the infection. The Bala Mitra 2.0 campaign aimed to enhance early detection and treatment in children. There are no grade 2 deformities reported among child patients, the officer said.

Treatment in government health centres is completely free.

State of affairs

State - Prevalence rate*

  • Kerala - 0.14

  • Tamil Nadu - 0.3

  • Karnataka - 0.3

  • Andhra Pradesh - 0.5

  • Telangana - 0.7

* Leprosy cases per 10,000 population; 2021-22 data

Source: Directorate General of Health Services (DGHS)

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