Current Leprosy Situation in Myanmar. Dr. Oke Soe Deputy Director(Leprosy) Department of Public Health

Transcription

1 Current Leprosy Situation in Myanmar Dr. Oke Soe Deputy Director(Leprosy) Department of Public Health

2 Demographic Information The Republic of the Union of Myanmar Area Sq:km - 676,578 Population State & Region - 14 Union Territory - 1 District - 74 Township Sub-township - 84 Village tract - 13,618 Village - 64,134 Ref; MOH, Health in Myanmar(2014) Population (2015 census) 2

3 Vision Leprosy Free Myanmar Mission Enhancing further reduction in Disease burden of leprosy Goal Enhancing reduction of leprosy disease burden and provision of high quality services for all affected communities, ensuring the principles of equity and social justice

4 Objectives ( ) Objective 1: Objective 2: Objective 3: Objective 4: Objective 5: Objective 6: Objective 7: To enhance political commitment To reduce the rate of newly diagnosed with grade-2 disabilities less than 1/million population by the year 2020 To reduce child disability grade-2 among new cases to zero by the year 2020 To sustain the Prevention of disability activities To enhance rehabilitation of LAPs (Leprosy Affected Persons) To strengthen proper monitoring, supervision, evaluation and surveillance. To enhance the use of basic and health system research

5 WHO Strategic Direction ( ) 1-S: Strategic Direction -1 Strengthen government ownership, co-ordination and partnerships 2-S: Strategic Direction-2 Stop leprosy and its transmission 3- S: Strategic Direction -3 Stop discrimination and promote inclusion

6 Top 22 Leprosy endemic countries (2014) o Angola o Bangladesh o Brazil o Comoros o Côte d lvoire o D R Congo o Egypt o Ethiopia o Federated States of Micronesia o India o Indonesia o Kiribati o Madagascar o Mozambique o Myanmar o Nepal o Nigeria o Philippines o South Sudan o Sri Lanka o Sudan o Tanzania 6

7 New Case Detection in WHO SEAR (2014) No Country New Case 1. India Indonesia Bangladesh Nepal Myanmar Sri Lanka Thailand Timor Bhutan Maldives 9

8 Milestones of Myanmar Leprosy Control Programme o Leprosy Control Programme started with Dapsone Monotherapy. o WHO MDT was introduced in Myanmar. At that time, the number of registered leprosy cases was and prevalence rate was 59.3 per population. o 1988-Nationwide MDT programme started in 6 hyper endemic areas. o Full integration with six hyper-endemic regions (1991 onwards) o 100% area coverage of MDT services (1995) o Achieved elimination target at

9 Milestones of Myanmar Leprosy Control Programme (Cont;) Activities after leprosy elimination o Case finding and MDT Treatment o Leprosy Awareness Campaign (LAC) in Pocket Areas o Prevention of Leprosy Related Disability (POD) activities o Capacity Building o Research o Post Exposure Prophylaxis of Leprosy Contacts o Leprosy Mapping Project o Partnership development and strengthening o Technical Advisory Group For Myanmar Leprosy Control 9

10 Leprosy indicators (From 2004 to 2016) Indicator Reg: PR NC NCDR MB Among NC < G II Female NA NA RFT

11 Graph showing leprosy prevalence from 1987 to

12 Graph showing new case detection (2004 to 2016) New Case

13 PCD & ACD (2016) % PCD ACD %

14 Number and proportion of new cases with Grade-2 disabilities % G-II Non G-II %

15 Female and Male new cases % Female Male % 15

16 PB and MB Cases (2016) % PB MB %

17 <15 years new cases (2016) 88 3% <15 > %

18 Top 6 Regions and 1 State in New Case Detection 2010 to 2016 Sr. No State/Region New cases 2010 New cases 2011 New cases 2012 New cases 2013 New cases 2014 New cases 2015 New cases Yangon Mandalay Sagaing Magway Shan Ayeyar waddy Bago Total

19 Low endemic 6 States, 1 Region and Nay Pyi Taw Union Territory in New Case Detection 2010 to 2016 Sr. No State/Region New cases 2010 New cases 2011 New cases 2012 New cases 2013 New cases 2014 New cases 2015 New cases Nay Pyi Taw Tanintharyi Kachin Chin Kayah Rakhaing Mon Kayin Total

20 Leprosy Awareness Campaign (LAC) o Leprosy Awareness Campaign (LAC) was conducted in 60 pocket health centers o 151 new leprosy cases were (PB=63, MB=88) o New cases with G-2 =11 (7.3%) o Under 15 child new cases=4 (2.6%)

21 Leprosy Awareness Campaign (LAC) o Leprosy Awareness Campaign (LAC) was conducted in 40 pocket health centers o 98 new leprosy cases were (PB=50, MB=48) o New cases with G-2 =6 (6.1%) o Under 15 child new cases=7 (7.1%) o Leprosy Awareness Campaign (LAC) will be conducted in 60 pocket health centers 2017.

22 Analysis of Current Situation o More than 80% of total new cases are by PCD. o 90% of the new cases are in top 6 regions and 1 state. o More than 70% of total new cases are MB cases. o Male and Female ratio is 2:1. o 10 to 15% of total new cases are G-2 disability cases. o 3 to 5% of total new cases are under 15 year of age. o Inadequate Manpower at the moment. o Pocket areas are still remaining. o POD activities are needed to be sustained 22

23 Challenges o Low priority after elimination among other disease o Misinterpretation on elimination and eradication of Leprosy o Weak infrastructure at operational level 1. Human Resources 2. Referral Centers o Active Case Detection is less than 20% o Low community awareness and participation o Weak monitoring and supervision at all level o Sustainability of POD activities in POD townships after project period. o Referral network o Presence of pocket areas o Stigma and discrimination 23

24 TOWARDS A LEPROSY FREE WORLD Thank you 24