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'sRepublic of China established a leprosy control programme in 1955.Between that year and the end of 1999, allowing for death and migration, the cumulative number of cases registered was 53,618, inciuding 120 cases on multiple drug therapy (MDT) and 18,248 who had completed satisfactory courses of dapsone monotherapy andlor MDT.Of this latter group, 9500 cases (52%) suffered from visible disabilities (grade 2 of the WHO ciassification).Prevalence and incidence rates of leprosy have decreased dramatically since 1955 and, on average, only 50-70 new cases are now being detected annually in the entire province.Leprosy is thus no longer a public health problem, but the existence of such a large number of patients with grade 2 disabilities is ciearly a matter of serious concern.This paper describes a pilot proj ect to investigate the potential of health personnel in the leprosy programme and the dermatology and sexually transmitted diseases services to (a) prevent deterioration of existing disabilities in ex-patients through self-care and (b) prevent new neuritis in patients on MDT through early detection and the use of steroids.Shandong Province (present population 89 million), in the People's Republic of China, is situated in the eastem, coastal part of the country.It has 17 prefectures and municipalities and 135 countries, with 80% of the population living in rural areas.With 573 people per square kilometre, it is one of the most densely populated provinces in the whole country.lA leprosy control programme was established in 1955.Between that year and the end of 1999, allowing for deaths and migration, the cumulative number of cases registered was 53,618, including 120 cases on multiple drug therapy (MDT), as recommended by the World Health Organisation (WHO) and 18,248 who had completed satisfactory courses of dapsone monotherapy and/or MDT.Of the latter group, 9500 (52%) suffered from visible disabilities