Leprosy Mailing List – May 16th, 2011
Ref: Leprosy situation in the Democratic republic of Congo.
From: J F Mukalay, Kinshasa/Gombe, Democratic Republic of Congo
Leprosy situation in the Democratic Republic of Congo.
1) Background:
Leprosy has been in Congo for many years. Historically, the fight against leprosy was organised through churches with the establishment of several leprosy villages in the nineteen fifties. So were built several leprosy settlement villages during the those years.
Today we can see some of these leprosy villages with fewer former old patients or only their descendants, who are actually living in those villages. However, the situation of leprosy villages in Congo is different from other countries that most of them are surrounded by non –leprosy affected villages.
- From Monotherapy era to WHO/ MDT: During the eighties the National Programme started to introduce MDT as treatment. Implementation was done through a vertical programme ,using specialized staff to go from one area to another to detect and follow up patients. The National leprosy Programme started to become a well organised integrate health programme in 1993. At the same time, Leprosy was combined with the TB at national and provincial levels. Provincial offices were leaded by a medical doctor. The medical doctor was responsible for both TB and Leprosy management. This combination of leprosy and TB at provincial level is still the current strategy to fight the two diseases.
- Steps towards leprosy elimination as public health problem:
Leprosy Elimination is defined by WHO as reaching a prevalence rate of less than 1 case per 10000 people.
Congo went through many strategies from 1995 like SAPEL (Special Actions Projects for Elimination of Leprosy), LEC (Leprosy Elimination Campaign ), Final push towards leprosy elimination from 2000 etc. The MB MDT regimen was reduced from 24 doses to 12 doses by 1998. This had an important impact on prevalence reduction. So was the change to a new leprosy case classification for all leprosy patients.
Finally on 31.12.2007, Congo officially had claimed to reach the elimination target at national level.
2) Leprosy in Congo today :
- Country national Trend of New Leprosy cases from 2000 to 2009
Year / Cases2000 / 4,028 / DRC TREND OF NEW LEPROSY CASES (see attached slides)
2001 / 4,855
2002 / 5,027
2003 / 7,472
2004 / 11,797
2005 / 9,65
2006 / 8,257
2007 / 8,82
2008 / 6,115
2009 / 5,062
What is Leprosy beyond 2009?
Leprosy prevalence rate as well as leprosy incidence have decreased. However, the remaining challenge is more to reinforce prevention of disability activities, and restore dignity of individuals, families, communities affected by leprosy through community based Rehabilitation projects.
Comments on the above data
Leprosy is still considered as a national public health problem: leprosy control programme is organised within 23 provincial coordination offices. Amongst these provincial health control units, some are recently created. It is a kind of policy to allocate defined provinces areas to different partners dealing with leprosy in the country.
For many years, TLM is responsible of leprosy work in Sankuru (Kasai Oriental North), South Kivu, Bas Congo (East & West), Maniema, Kasai Oriental South, Kasai Occidental. ALM is most fighting leprosy in Equateur North (Ubangi) and Equateur East (Mongala). The remaining other provinces are allocated to Damien Foundation such are Kinshasa, Bandundu, Equateur South, Province Orientale, Nord Kivu and Katanga.
What the situation of leprosy in each province? (see attached slides)
The entire country level has declared to achieve the elimination WHO target at end of 2007. Actually there are very few provinces noticing significant number of new cases like: Bandundu North, Equateur South, Province Oriental West, Katanga North specifically Moba Health district which is still detecting yearly more than a thousand new cases.
This can give an idea on leprosy Map in Congo today, but this depends on the work quality where people are committed to leprosy.
Jean Mukalay
The Leprosy Mission Congo
124, Avenue Mongala,
Kinshasa/Gombe,
P.O. BOX 14 347 KIN 1
Democratic Republic of Congo
LML - S Deepak, S Noto, P Schreuder
LML Archives: http://www.aifo.it/english/resources/online/lml-archives/index.htm
Dr Salvatore Noto
Padiglione Dermatologia Sociale
Az. Ospedaliera Universitaria S. Martino
Largo R. Benzi, 10
16132 Genoa, Italy
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