Leprosy in Africa: a contrasted picture

摘要

There is no doubt that the goal of the Elimination of Leprosy as a public health problem, as adopted by the World Health Assembly in 1991, has had a very positive impact on the leprosy situation. Globally, more attention has been given to leprosy by political authorities and Ministries of Health during the last decades than ever before in history, and much progress has been achieved. This is also true for Africa: while a kind of routine had been prevailing for many years in often vertically organized leprosy services, a new impetus was given in all countries. The results of this are impressive. According to official statistics, the number of leprosy cases registered for treatment in the African Region of WHO has decreased by more than 50% between 1995 and 2003, mainly thanks to the generalization of the use of the WHO MDT regimens. The registered prevalence rate is now 0·8 per 10,000 for the whole Region. It is above 1 per 10,000 in only seven of the 46 countries of the Region (Angola, Central African Republic, Comoros, DR Congo, Madagascar, Mozambique and Tanzania), of which three countries only (Angola, Madagascar and Mozambique) are officially recognized at risk of not achieving the Elimination goal by the end of the year 2005. What is more, it has been reported from several countries where surveys have been carried out, that many registered patients should have long been discharged (patients having completed treatment, having disappeared or died who remain in the registers for years,...) or should not have been registered at all (re-registration of previously treated patients and cured patients, wrong diagnoses).