THE Union Territory of Dadra and Nagar Haveli has seen a 138 per cent increase in leprosy prevalence between 2006 and 2014, causing concern among researchers and government officials. In the same period, the country’s leprosy prevalence reduced by 14 per cent. A team appointed by the Indian Council of Medical Research (ICMR) has visited the Union Territory twice, the latest in the last week of March, to understand the reasons for such a high incidence of leprosy in the region.
According to government figures, the Union Territory has a leprosy prevalence of 6.2 cases per 10,000 population in 2016-17, a dramatic rise from 1.88 cases per 10,000 population noted in 2007-08. In contrast, India’s average leprosy prevalence rate is 0.6 cases per 10,000 people. The latest report submitted to the ICMR by a team of researchers cites poor ventilation, the large tribal population in the Union Territory, the thick forest cover and hilly terrain as possible factors for the high incidence of the disease.
Of its population of 3.42 lakh, Dadra and Nagar Haveli has a 52 per cent tribal population, people living mostly in mud houses with poor hygiene. In 2015, 660 leprosy patients were enrolled under the National Leprosy Eradication Programme (NLEP) in Dadra and Nagar Haveli, while in 2016, 434 patients were treated. The report claims this year 325 new cases have been diagnosed.
“After India declared the eradication of leprosy in 2005, all states except four have seen a drop in leprosy cases. But cases in Dadra and Nagar Haveli are exceptionally high. They seem to increase every year,” said Dr V V Pai, director of the Bombay Leprosy Project and member of the ICMR committee that visited the region. “We will also check if patients there are resistant to first line of drugs. So far the mycobacterium laprae has not commonly developed resistance to Rifampicin drug (to treat leprosy) anywhere in the world,” he added.
Also worrying is the relatively higher number of cases of children affected by leprosy. In 2007-08, 25 children were diagnosed with leprosy in the Union Territory, while in 2016-17, 66 children were diagnosed. Dadra and Nagar Haveli has one district hospital and 11 primary health centres. The highest burden of leprosy cases has been found in the Amboli, Dapada and Kilwani regions.
“Dadra and Nagar Haveli has a traditionally high rate of leprosy. The leprosy program has been strengthened there over the years. It is good that so many cases are being detected, that means in a year or so we will also see a decline there,” said ICMR director Dr Soumya Swaminathan.
In 2016, the government screened high-prevalence districts and found 34,000 new cases of leprosy living undetected in India. In a recent World Health Organisation report, India was said to have 60 per cent of the world’s leprosy cases. A leprosy vaccine has now been launched on a pilot basis in five districts of Bihar and Gujarat and a software to monitor it is being developed.
The report submitted to ICMR shows a high prevalence of leprosy in the belt lining Gujarat, Dadra and Nagar Haveli and in Maharashtra where tribals reside.
