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Towards zero leprosy. Global leprosy (‎Hansen’s Disease)‎ strategy 2021–2030

WORLD HEALTH ORGANISATION (WHO), REGIONAL OFFICE FOR SOUTH-EAST ASIA
April 2021

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The Global Leprosy Strategy 2021–2030 “Towards zero leprosy” was developed through a broad consultative process with all major stakeholders during 2019 and 2020. Valuable inputs were provided by national leprosy programme managers, technical agencies, public health and leprosy experts, funding agencies and persons or members of communities directly affected by leprosy.

The Strategy aims to contribute to achieving the Sustainable Development Goals. It is structured along four pillars:

(‎i)‎ implement integrated, country-owned zero leprosy road maps in all endemic countries;
(‎ii)‎ scale up leprosy prevention alongside integrated active case detection;
(‎iii)‎ manage leprosy and its complications and prevent new disability; and
(‎iv)‎ combat stigma and ensure human rights are respected. Interruption of transmission and elimination of disease are at the core of the Strategy

Economic assessment of a community-based care package for people with lower limb disorder caused by lymphatic filariasis, podoconiosis and leprosy in Ethiopia

HOUNSOME, Natalia
KINFE, Mersha
SEMRAU, Maya
ALI, Oumer
TESFAYE, Abraham
MENGISTE, Asrat
BREMNER, Stephen
AHMED, Abdulkadir
FEKADU, Abebaw
DAVEY, Gail
December 2020

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We conducted an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine healthcare in Gusha cluster, Guagusa Shikudad district, northwest Ethiopia. The healthcare package included training patients in lower limb hygiene and skin care and provision of shoes, hygiene supplies and medication. The implementation activities included training events, workshops, awareness raising, self-help groups, supportive supervision, staff secondments and advisory board meeting. 

 

Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 114, Issue 12, December 2020, Pages 1021–1034

https://doi.org/10.1093/trstmh/traa111
 

Activity Limitation of People Affected by Leprosy in an Endemic District in West Bengal, India

Govindharaj, Pitchaimani
Srinivasan, Sampathkumar
Darlong, Joydeepa
2020

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Purpose: This study aimed to assess the level of activity limitation, and the factors associated with it, among people affected by leprosy who were reporting at a leprosy referral centre of Purulia, in West Bengal state, India.

 

Method: A cross-sectional study was conducted among 358 individuals affected by leprosy. Persons recruited for this study were above 18 years of age, married, and had been diagnosed with leprosy for at least 1 year at the time of the interview. A semi-structured questionnaire was used to gather information about the respondents’ socio-economic and disease status. The Screening of Activity Limitation and Safety Awareness (SALSA) Scale was used to measure activity limitation.

 

Results: Of the 358 respondents, 59% were male, 60% were between 18 and 45 years of age, and 42% were illiterate. About 144 or 40% of the respondents had Grade 2 disability and 60% had disease duration of more than 3 years. There were 229 individuals (64%) who had no limitation in activities, 103 (29%) had mild limitation and 26 (7%) had moderate to severe limitation in activities. There is a significant association between gender, age, occupation, physical disability and disease duration with activity limitation.

 

Conclusion: It appears that limitations in activities among persons affected by leprosy are associated with being a woman, ahousewife, an aged person, and with longer disease duration. The physical disability was intrinsically associated with limitation in activities.

Disclosure of Disease among Women affected by Leprosy: A Qualitative Study

Ramasamy, Senthilkumar
Govindharaj, Pitchaimani
Kumar, Archana
Panneerselvam, Suganya
2020

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Purpose: Although leprosy is completely curable with multidrug therapy, it is unfortunate that the stigma attached to leprosy persists even today. Fear of social exclusion prevents disclosure of the disease to the family and community. This study aimed to evaluate the extent of disclosure of disease among women affected by leprosy in a tertiary referral hospital in Chhattisgarh State, India.

 

Method: A qualitative study was conducted with 57 women affected by leprosy who reported at a tertiary referral hospital in Champa, Chhattisgarh State. The respondents were 18 years of age or older, and had completed multidrug therapy for leprosy. They were asked whether the disclosure of disease had affected their interactions with family, neighbours and community members.

 

Results: Of the 57 women, 48 (84%) had disclosed their disease to their family, 17 (30%) to their neighbours and 13 (23%) to the community members. Thirty women (53%) reported that they experienced problems after revealing the ailment to their family, friends and neighbours. The qualitative analysis found that negative behaviour towards people affected by leprosy still persists in the community. Consequently, women affected by leprosy try to hide their disease due to fear of negative community reactions.

 

Conclusion: This study emphasises the need to spread awareness about the disease and its transmission, by educating the people affected by leprosy, their families and the community. This should be a continuous process in order to reduce or remove the stigma and discrimination against women affected by leprosy, in particular.

User Satisfaction with Conventional Lower-Limb Orthotic Devices: a Cross-Sectional Survey in Pakistan

Aftab, Zohaib
Zaidi, Zohaib Ahmed
Shafi, Faraz
2020

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Purpose: Persons with disabilities affecting lower-limb function use ankle- foot-orthoses (AFO) and knee-ankle-foot-orthoses (KAFO) on a regular basis. However, the effectiveness of these devices in daily use is seldom evaluated, especially in the developing world. This study aimed to evaluate user satisfaction with lower-limb orthotic devices while performing a broad spectrum of daily life activities in Pakistan, and to document the desired outcomes.

 

Method: A survey was conducted among orthotic device users in the out-patient departments of three hospitals in Lahore, Pakistan. The survey questionnaire was devised by adapting the Prosthetic Evaluation Questionnaire to suit orthotics evaluation. Fifty-four AFO and KAFO users participated in the study.

 

Results: Most users felt comfortable while walking on even surfaces with their orthoses. However, donning/doffing these, climbing stairs and performing certain routine activities were considered problematic for most people. Energy conservation was the most desired AFO feature, while the KAFO users wanted automatic knee-joint function.

 

Conclusion and Implications: Overall satisfaction with the existing lower- limb orthoses is adequate. Yet, significant improvements are needed in terms of energy efficiency and comfort while walking on different terrains. Further research is required in order to improve the functioning of the existing orthotic devices.

Global Leprosy Update 2019

WORLD HEALTH ORGANISATION (WHO)
September 2020

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A yearly update providing data from 160 countries around the world on the state of leprosy. The data will be useful to policy-makers, planners and researchers. 

The main leprosy indicators are now all based on a denominator of 1 million population. The key indicators are the case detection rate, the disability rate and the case detection rate in children.

The sub-title, “Time to step-up prevention initiatives” is the main focus of the Editorial comment on the last 3 pages, emphasizing the Triple Zero targets

 

Weekly Epidemiological Record  4 SEPTEMBER 2020, 95th YEAR No 36, 2020, 95, 417–440

 

What do we know about how to support mental health and wellbeing during the COVID-19 pandemic from past infectious disease epidemics?

QURESH, Onaiza
SCHERER, Nathaniel
July 2020

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The question and the problem:

Symptoms of mental ill-health are common during widespread outbreak of an infectious disease, with high rates of depression, anxiety and post-traumatic stress disorder (PTSD) reported during recent epidemics, such as the recent Ebola crises and SARS-CoV-1. Elevated symptoms of mental ill-health are not limited to patients only, and are seen in healthcare workers, family members and indeed more widely across the general population. Early evidence coming from the COVID-19 pandemic demonstrates high rates of mental ill-health and mental health service provision is needed. This evidence brief summarises evidence on mental health support during COVID-19 and other recent pandemics, informing policy and practice during this crisis.

COVID-19 and Disability; Exploring a new innovation landscape

HOLLOWAY, Catherine
OLDFREY, Ben
CHIIRA, Bernard
KETT, Maria
July 2020

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This webinar explored the impact of, and learnings from COVID-19 on Disability Innovation. We heard from those shifting their work in response to the pandemic. We also looked at how learnings from Assistive Technology (AT) are being applied to this unprecedented global environment.

Finally, there was an overview of how knowledge was captured during Ebola can support the response to this latest threat

Persons affected by leprosy and the COVID-19 global health crisis

GLOBAL PARTNERSHIP FOR ZERO LEPROSY (GPZL) WORKING GROUP 2
June 2020

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The COVID-19 pandemic has deeply impacted leprosy control and prevention and the lives of persons affected by the disease.

Seven consultative calls were carried out with persons affected individuals and organizations from April – May 2020, speaking with over 100 individuals from more than 25 organizations from 22 different countries. The first six calls were conducted based on geographical region, including: Latin America, Africa, Asia, and the Pacific. The final call was for women affected by leprosy.

The following issues were raised on a consistent basis, across geographies, as major concerns for persons affected during the COVID-19 pandemic:

  • Access to health care
  • Access to fundamental goods
  • Access to government support
  • Access to stable livelihoods
  • Access to information about COVID-19
  • Intersecting vulnerabilities

Guidance for including people with disabilities in responses to the COVID-19 pandemic. Guidance for development partners

PREGEL, Andrea
LE FANU, Guy
May 2020

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Practical guidance is provided for development partners to develop disability inclusive responses to the COVID-19 pandemic during the emergency phase of the COVID19 pandemic. In the immediate- and long-term response to the pandemic, it is vital that all development partners take steps to strengthen health systems that are disability-inclusive.

 

Topics include: intersectionality; assessing gaps and needs; engaging people with disabilities and DPO's; accessible and inclusive communications; healthcare and essential services; livelihoods and social protection; education; independent living and housing; and evidence generation.

Voices of people with disabilities during the COVID19 outbreak

INTERNATIONAL DISABILITY ALLIANCE (IDA)
May 2020

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A collection of stories from people with various disabilities across the globe sharing their experiences with the COVID-19 outbreak and pandemic risk reduction strategies implemented by their governments. Some stories are written by IDA and some are external.

Examples are:

  • How absence of transport can be fatal: A Story from Uganda
  • In Uganda, a Deaf man loses his leg after being shot during curfew
  • Voices of Mexico: Disability and COVID-19 | Voces de Mexico: Discapacidad y COVID-19
  • COVID-19 in Mexico: the experience of deafblind children told by their mothers (Espanōl)
  • Reaching Persons with Deafblindness
  • COVID-19 and The Forgotten People (Indonesia)
  • When accessible information is far from a reality: Zimbabwe during COVID-19
  • The experience of a blind woman in Kenya under COVID-19 outbreak
  • Being a single mother of two persons with disabilities under COVID-19 (South Africa)
  • Autistic students in South Africa: how has their life changed?
  • The Story of Rose Rokiatou: COVID-19 Pandemic and Financial Vulnerability of Persons with Disability in Mali
  • COVID-19 in Romania: Life-threatening situations reported
  • COVID-19 in Nepal: What are the challenges for indigenous persons with disabilities?
  • COVID-19 in India : Technology can be your best friend or worst enemy

Persons with disabilities must not bear the brunt of COVID-19 aftermath: Lessons from Ebola in Liberia (SDDirect COVID-19 pandemic blog series)

CAREW, Mark
May 2020

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The importance of ensuring persons with disabilities are not excluded as part of COVID-19 responses is explored.
Lessons learnt from the 2014-2017 Ebola outbreak in Liberia are discussed highlighting access to information, access to healthcare and the social impact. Research in Liberia combined surveys and interviews with people from households with a disabled person as well as those without, and included responses from 560 persons living in areas that had ‘many’ or ‘few’ cases of Ebola.

Disability progression among leprosy patients released from treatment: a survival analysis

dos Santos, Aleksandra Rosento
et al
May 2020

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Leprosy can be cured, but physical disability (PD) as a result of the infection can progress in the post-release from treatment phase. This study evaluated the likelihood of, and factors associated with, the progression of the PD grade post-release from treatment among leprosy patients treated in Cáceres-MT, Brazil in the period 2000 to 2017.

A retrospective cohort study and survival analysis were performed in the hyperendemic municipality of Cáceres in the state of Mato Grosso. The study population consisted of newly diagnosed leprosy patients released from treatment between January 1, 2000 and December 31, 2017.

 

Infect Dis Poverty 9, 53 (2020)

https://doi.org/10.1186/s40249-020-00669-4

Management of leprosy reactions and prevention of disability

WORLD HEALTH ORGANISATION (WHO), REGIONAL OFFICE FOR SOUTH-EAST ASIA
May 2020

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The World Health Organisation has issued new Technical Guidance on management of leprosy reactions and prevention of disability. The guidance originated in an informal consultation in late 2018 where numerous ILEP technical specialists were involved.

The Technical Guidance provides updated and detailed guidance on critically important actions to prevent disability. Main chapters include:

  • Distinction between the different types of leprosy reaction – how they present, how they are managed and the potential consequences if not managed well
  • How to assess nerve function and undertake sensory testing and voluntary muscle testing, so as to recognise nerve damage as early as possible
  • How to recognise early, and correctly treat, leprosy reactions and neuritis, so as to avoid irreversible nerve damage and the resulting disability. There are separate chapters for the medical management and for front-line health workers, including a useful step-by-step guide

A feature that users may find especially useful is a set of flow-charts, or algorithms, towards the end of the publication, which are a visual guide to making the right clinical decisions.

#COVID-19 ASL

CENTRE FOR DISEASE CONTROL AND PREVENTION (CDC)
April 2020

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A series of 11 short videos in American sign language giving information on various aspects of COVID-19

COVID-19: Older people's stories

HELPAGE INTERNATIONAL
April 2020

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HelpAge International is working with older people and network members around the world to respond to the threat of the coronavirus (COVID-19) pandemic.

The experiences of older people and how they are responding to the spread of the virus are available.

 

Guidance available includes: COVID-19 in general; for care homes; administering pensions; collecting pensions; for communities and older persons associations.

 

Briefing notes include: older people and COVID-19 in low- and middle-income countries and humanitarian settings; and key messages for decision makers. 

 

Many resources are available with some also available in Arabic, Russian and Spanish. 

Applying humanitarian standards to fight COVID-19

SPHERE
April 2020

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Contents of this short brief include:

  • Sphere Standards
  • The Core Humanitarian Standard
  • The Humanitarian Standards Partnership
  • Cash Assistance
  • Inclusion of older people and people with disabilities
  • Education in Emergencies
  • Child Protection
  • Markets and Economic Recovery 

COVID-19 response: Considerations for children and adults with disabilities

UNICEF
April 2020

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A guidance note on considerations for children and adults with disabilities in the COVID-19 response. The guidance describes what we need to know about the situation of persons with disabilities in COVID-19 response, and what we need to do in five key points: Limit human to human transmission and protect individuals from exposure; minimise morbidity and mortality; prevent and address the secondary impact of the outbreak- minimise the human consequences of the outbreak; enhance risk reduction and in-country preparedness including coordination; inclusion in UNICEF operations

Coronavirus disease (COVID-19) outbreak. Video gallery

WORLD HEALTH ORGANISATION (WHO). REGIONAL OFFICE FOR EUROPE
April 2020

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Several short videos concerning COVID-19 are available including:

  • Seven steps to prevent the spread of the virus
  • How to protect yourself against COVID-19
  • How is the new coronavirus affecting people who get it?
  • What is the correct way to wear and dispose of masks?
  • Why is it recommended to avoid close contact with anyone who has fever and cough?
  • Q&A on Coronavirus - COVID-19 in the workplace - WHO's Dr Rosamund Lewis

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