Leprosy elimination

WHO Seventh Expert Committee (June 1997)

Executive Summary

The WHO Expert Committee on Leprosy met in Geneva from 26 May to 3 June 1997 to review the global state of leprosy and the technology for dealing with it, to identify the remaining obstacles to reaching the goal of elimination, and to make technical and operational recommendations related to elimination and beyond.

Definition of a case of leprosy

A case of leprosy is a person having one or more of the following features, and who has yet to complete a full course of treatment: - hypopigmented or reddish skin lesion(s) with definite loss of sensation; - involvement of the peripheral nerves, as demonstrated by definite thickening with loss of sensation; - skin smear positive for acid-fast bacilli. The case definition includes retrieved defaulters having signs of active disease as well as relapsed cases who have previously completed a full course of treatment, but does not include cured persons with late reactions or residual disabilities.

Clinical classification for control programmes

Since single-lesion leprosy may be cured by a shorter regimen than the standard MDT for PB leprosy, the Committee suggested that patients be classified into three groups: (a) PB single-lesion leprosy (one skin lesion); (b) PB leprosy (2-5 skin lesions); and (c) MB leprosy (more than 5 skin lesions).