United Republic of Tanzania

History of leprosy in the United Republic of Tanzania

The Tanzania National Archives house documents relating to leprosy from 1927 – 1955: http://www.leprosyhistory.org/cgi-bin/showdetails.pl?ID=177&type=Archive

Until 1996 treatment consisted of various combinations of Rifampicin and Isoprodian. 

Tanzania was among the first countries to successfully combine control of leprosy and tuberculosis in one programme. The National Tuberculosis and Leprosy Programme (NTLP) was launched by the Ministry of Health and Social Welfare in 1977. The mission of the programme is to provide high quality and effective interventions to control leprosy and TB, focussing on gender mainstreaming, equity, accessibility and those most at risk.

Multi-drug therapy was introduced into the NTLP in 1983 and nationwide coverage was reached in 1990. This resulted in a rapid decline in the number of registered leprosy cases on treatment from nearly 35,000 cases in 1983 to about 5,000 in 2000.

The NTLP uses Leprosy Elimination Campaigns (LECs) to detect all undetected cases of leprosy as early as possible by raising community awareness and increasing the capacity of health workers.  It also conducts Special Action Programmes for Eliminating Leprosy (SAPELs), which aim to provide MDT services for patients living in areas that are difficult to access or those living in isolated population groups such as nomads, fisherman, islanders and prisoners.

In 1998 the Ministry of Health used five separate surveillance systems to monitor infectious diseases, including one for TB and leprosy. All health facilities with TB/leprosy surveillance had outpatient registers and 83% of them had an adequate supply of outpatient register books in the six months preceding the assessment. Supervision of surveillance at the regional and district level was most regularly performed in the TB/Leprosy system. 

There were approximately 20,000 with disabilities as a result of leprosy living in Tanzania in 2002 in need of assistance.

In 2003 Brazil, India, Madagascar, Mozambique and Nepal, the United Republic of Tanzania accounted for 83% of the leprosy cases in the world.

Tanzania reached less than one case of leprosy per 10,000 inhabitants during 2006, except for the islands of Zanzibar and Pemba.

Current objectives of the NTLP (to be achieved by 2009) include:

• To increase case detection and cure rates of leprosy by 5% and to reduce disability grade II of newly diagnosed leprosy patients by 5%.
• To develop human resources and strengthen management of leprosy service delivery at all levels.
• To strengthen the quality of the NTLP management information system with gender mainstreaming at all levels.
• To determine and monitor the magnitude of the leprosy burden in Tanzania by 2009.
• To involve communities in leprosy care by 2009. 

Today health-care workers co-exist peacefully with traditional religious healers even though the latter have had superstitious beliefs about the causes of leprosy. Now they know how to identify leprosy and can deliver the drugs to cure it.

The following book may also be of interest:
A History of Leprosy in Tanzania by Balslev Krund,1989
African Medical and Research Foundation and recently reprinted by
Deutshe Lepra- und Tuberkulosehilfe

Maskini

“Maskini” is the word used by Tanzanians to refer to people on the margins such as persons disfigured by disease and those with disabilities or impairments.