Prevalence rate of leprosy in Brazil
To the Editor:
I was most interested to read the article on Monitoring the Elimination of Leprosy in Brazil by Andrade, et al. in the International Journal of Leprosy 66 (1998) 457-463. This is clearly a most valuable description of the progress being made toward the elimination of leprosy as a public health problem in Brazil, based on the declining prevalence rate since multiple drug therapy (MDT), as advised by the World Health Organization, was introduced in 1990.
I was however surprised and somewhat disconcerted to read in the Discussion and Summary that ". . . defaulters and patients being treated with old regimens are kept on the active registers in Brazil.. . ." The authors rightly add that this is not the case in most other leprosy-endemic countries.
Until reading this article, I must confess that I did not know that this is the situation in Brazil. Many of those who are striving, directly or indirectly, to achieve the elimination of leprosy in this country may share my concern that the current official prevalence rate (6.72/10,000 of the population) is being affected by this policy.
I write to ask if the authors could comment on any steps which have been taken, perhaps through the World Health Organization, the Pan-American Health Organization or the International Federation of Anti-Leprosy Associations, to remedy this situation and bring it into line with operational and statistical norms in other leprosyendemic countries.
- A. Colin McDougall, M.D., F.R.C.P.
Department of Dermatology
The Churchill Hospital, Headington
Oxford OX3 7LJ, U.K.
Reprint requests to Dr. McDougall, 87 Lower Radley, Near Abingdon, Oxfordshire, OX14 3BA, U.K.