ILEP Technical Bulletins
Technical Bulletins
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1. BASIC REQUIREMENTS FOR THE IMPLEMENTATION OF MULTIDRUG THERAPY
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
2. RECOMMENDATIONS TO ILEP MEMBER-ASSOCIATIONS FOR THE USE OF BLISTER CALENDAR PACKS IN LEPROSY CONTROL PROGRAMMES
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
3. IMPROVING SKIN SMEARS & THE READING OF THE BACTERIOLOGICAL INDEX IN MDT LEPROSY CONTROL PROGRAMMES
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
4. PRELIMINARY RECOMMENDATIONS ON THE USE OF SURGERY FOR THE TREATMENT OF LEPROSY NEURITIS: CAUTION CONCERNING THE USE OF SURGERY IN PREVENTION OF DEFORMITIES
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
5. WORKING PROCEDURES TO AVOID HIV INFECTION - ADVICE TO HEALTH STAFF INVOLVED IN LEPROSY CONTROL ACTIVITIES
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
6. POSSIBLE CHEMOTHERAPY OF RIFAMPICIN-RESISTANT LEPROSY
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
7. ACHIEVING MDT FOR ALL LEPROSY PATIENTS
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
8. PREVENTION OF DISABILITY IN LEPROSY
The overall aim of leprosy control programmes is to prevent disabilities. This current point in time presents a unique opportunity to implement specific disability prevention activities as a result of the successful implementation of MDT. Stigma is reducing and the hand over to integrated programmes allows the possibility of POD being introduced at a primary care level.
9. THE MANAGEMENT OF ERYTHEMA NODOSUM LEPROSUM
Immunologically mediated episodes of acute or subacute inflammation known as a reaction, may occur in any type of leprosy except indeterminate. Unless reactions are promptly and adequately treated they can result in permanent deformity. Most reactions belong to one of two major types, erythema nodosum leprosum (ENL) or type 2 reaction or reversal reaction (type 1 reaction).
10. PRIORITIES FOR LEPROSY RESEARCH
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
11. DETECTING HARD TO REACH LEPROSY PATIENTS
At the beginning of 1997, about 890,000 leprosy patients were registered for chemotherapy, globally. The World Health Organisation estimates that the true prevalence of patients in need of chemotherapy is about 1,150,000 patients. This estimate was reached through information provided by national programme managers from endemic countries, taking into account registered figures, health service coverage and MDT implementation. This means that there would presently be a gap of about 260,000 undetected patients. This is an approximate figure, since population surveys conducted in different areas often showed that there were two to three times more patients than reported through the registered figures.
12. EARLY DETECTION AND TREATMENT OF REVERSAL REACTION UNDER FIELD CONDITIONS
Leprosy reactions are the main cause of acute nerve damage and disability in leprosy. Reactions are caused by changes in the immune response of the patient to the mycobacteria. There are two types of reaction, reversal reaction or type 1 reaction and erythema nodosum leprosum (ENL) or type 2 reaction. (ILEP Technical Bulletin 9 describes the management of ENL reaction).
Reversal reactions often occur in the first 6 months of multidrug therapy (MDT) and may occur in both paucibacillary (PB) and multibacillary leprosy (MB), but more commonly in MB. Sometimes patients are found to have reversal reactions at the time of diagnosis and it may be the symptoms of the reaction which makes the patient aware of the disease. A reversal reaction may occur after completion of MDT, particularly when short duration regimens are used.
13. PLANNING HEALTH EDUCATION INTERVENTIONS
Health Education activities have an important role to play in leprosy control programmes. The changing epidemiological situation of leprosy in different geographical areas of the world may mean that the strategies for Health Education need to be reviewed.
14. OPERATIONAL GUIDELINES FOR THE INTRODUCTION OF NEW MDT REGIMENS FOR THE TREATMENT OF LEPROSY
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
15. GUIDELINES FOR IDENTIFYING PATIENTS FOR REFERRAL SURGERY
These guidelines are designed for programme managers as a framework for training their staff in identifying individual patients affected by leprosy, who would benefit from reconstructive surgery or other forms of surgery. It is important that centres doing reconstructive surgery in leprosy liaise with field workers in developing local criteria and arrangements for the referral of appropriate patients.
16. THE ILA TECHNICAL FORUM - IMPLICATIONS FOR LEPROSY CONTROL PROGRAMMES
This Bulletin has been archived. To obtain a copy please contact the ILEP office.
17. A TOOLKIT FOR MEASURING THE QUALITY OF LEPROSY SERVICES
Quality of service provision may be defined in different ways by different stakeholders. In the provision of healthcare there are two main groups to be considered, the providers and the service users. Providers have a mandate to make healthcare services available to their target population, with the long-term goal of improving health outcomes. No health service provision could be regarded as of high quality without routine provision for examining and acting upon the views of service users.