BACK GROUND

One of the newly formed state.

It has got 13 districts out of which 7 districts are high Himalaya, 4 districts are mid Himalaya & 2 districts are plain.

Total Area of the State is 53,204 Sq. Km.

Total Est. population of State on 2004 90,92,366

The State specific constraints –

- Difficult hilly terrains

- Poor road connections

- Lack of man power & infrastructure

- Sparsely populated villages.

All contribute problems of access to health service delivery.

The objective of the project was to reduce the PR of leprosy to 1 or below 1/10,000.

The PR of the Uttranchal as on March 2004 was 1.37/10,000.

Status as on January 2005

Total districts 13.PR – 1 or below 1 10 Distts.PR – 1 – 2 2 Distts. (D.Dun, U.S.Nagar)PR – 2 – 5 1 Distt. (Haridwar)

Prevalence Rate as on January 2005 - 1.09 per 10,000

OBJECTIVE

UTTARANCHAL LEPROSY STATUS

C h a m o l i

U t ta r K a s h i

Pauri

P i th o r a g a r h

A lm o r a

N a in it a l

T e h r i G a r h w a l

D e h r a d u n

rHARDWAR B a g e s w a r

U. S. Nagar

C h a m p a w a t

RudraPrayag

AS ON MARCH 2004

PR/10,000 Popll.

PR <1\10000

PR 1-2\10000

PR>2-5

24(0.77)

22(0.56)

31(0.63)

10(0.38)

14(0.58)

66(0.48)

41(0.64)

604(3.96)

83(1.13)

20(0.30)

15

(0.63)65(0.80) 231

(1.77)

PROGRESS OF NLEP IN LAST 5 YEARS (New Cases)

1894

25412246

1917

1093

0

500

1000

1500

2000

2500

3000

NEW CASES

2000-01

2001-02

2002-03

2003-04

Upto Jan 2005

PROGRESS OF NLEP IN LAST 5 YEARS (Balance Cases)

1449

1913

1655

1226993

0200400600800

100012001400160018002000

BALANCE CASES

2000-01

2001-02

2002-03

2003-04

UP TO Jan 05

COMPARATIVE PR FOR LAST 5 YEAR

2.26 2.22

1.85

1.37 1.09

0

0.5

1

1.5

2

2.5

PR

2000-012001-02

2002-03

2003-04Upto Jan. 2005

11.90%

2.30%2% 1.80%

1.20%

0.00%

2.00%

4.00%

6.00%

8.00%

10.00%

12.00%

DEFORM CASES

2000-012001-022002-032003-04Upto Jan. 05

COMPARATIVE CHART OF DEFORM CASES FOR THE LAST 5 YEARS

COMPARATIVE CHART OF CHILD CASES FOR THE LAST 5 YEARS

2.67%

7.75%8%

6.50%

8.80%

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

CHILD CASES

2000-012001-022002-032003-04Upto Jan. 05

Proportion of MB Case Among New Cases

46.53 45.93

38.2534.99

37.1944.73

0

10

20

30

40

50

60

70

80

MB CASES

1999-002000-012001-022002-032003-04Jan 05

NCDR Trends Uttranchal

1.09

2.76

2.23 2.14

1.74 1.78

2.26

1.8

2.21

1.37

2.962.51

2.56

1.88

0

0.5

1

1.5

2

2.5

3

3.5

97-98 98-99 99-2000 2000-01 2001-02 2002-03 2003-04

NCDR

PR

NLEP INDICATORS OF UTTRANCHAL

Indicators

National Status as on

March 04

Uttranchal Status as on

March 04

Uttranchal Status as on Jan.05

PR/10,000 2.44 1.37 1.09

PR<1 in districts 42% 76.92% 76.92%

VD among New Cases 1.40% 1.25% 1.18%

ANCDR 3.3% 2.14% 1.2%

MB Proportion 39% 37.19% 44.73%

Female Proportion 35% 36.67% 30.74%

Child Proportion  13.77% 6.46% 8.78%

High PR Blocks of Uttranchal has been identified by calculating PR of all 95 blocks. In September 2004 Only 19 blocks has PR > 1, which needs more attention.

March04 Sept04Total No. of Blocks 95 95PR < 1 72 76PR between 1 – 2 14 10PR between 2 – 5 7 9PR between 5 – 10 2 0Zero PR Blocks 9 20

Priority District Haridwar

Haridwar is our top priority District. It has 6 blocks containing 503 villages. PR of all the villages having balance cases as on March 03 identified, necessary action taken due to which significant reduction of PR achieved as shown by the Comparative village wise PR given below:

March 03 Sept 04Nos of vill. with PR >10 114 71Nos of Vill. with PR 5-10 55 65Nos of Vill. With PR <5 70 42Total Vill. Affected 239 178% of affected Vill. 47.5% 35.3%

Out of 178 villages 69 are newly affected villages.

Priority District U.S. Nagar

This district has second highest number of leprosy cases. There are 7 blocks in the district. The comparative block wise PR as on March 04 & Sept 04 is as under:

March04 Sept04Total No. of Blocks 7 7PR < 1 0 1PR between 1 – 2 4 2PR between 2 – 5 3 4PR between 5 – 10 0 0

Village wise PR of U.S. Nagar

U.S. Nagar being the 2nd district having more number of leprosy cases were again taken up for calculating village wise prevalence rate, so that high risk pockets can be identified for effective implementation of the programme.

Sept 04Total Nos of Villages 910Nos of vill. with PR >10 73Nos of Vill. with PR 5-10 25Nos of Vill. With PR <5 19Total Vill. Affected 117% of affected Vill. 12.8%

NLEP PHYSICAL PROGRESS REPORT JANUARY 2005

S.No.

Name of Districts

Nos of Cases

at the at the Beginning

of the Year 2004-05

Nos of Newly Detected Cases During the Current

Financial YearUpto Jan.2005 RFT

Cases

Nos of Cases

Balance at the end of Jan. 2005

PR Jan. 2005

Per 10,000

PB MB Total

1 PAURI 46 1 8 9 59 52 0.7

2 DEHRADUN 146 4 2 6 83 145 1.06

3 TEHRI 13 0 0 0 45 13 0.2

4 CHAMOLI 12 0 0 0 16 12 0.3

5 RUDRAPRAYAG 13 0 0 0 10 13 0.53

6 UTTARKASHI 12 0 0 0 21 11 0.35

7 HARIDWAR 450 9 2 11 598 418 2.7

8 ALMORA 9 0 0 0 20 8 0.12

9 NANITAL 101 1 5 6 28 70 0.86

10 PITHORAGARH 25 0 1 1 28 25 0.5

11 CHAMPAWAT 14 1 1 2 22 14 0.58

12 BAGESHWAR 7 1 0 1 7 8 0.3

13UDHAM SINGH NAGAR 214 11 3 14 224 204 1.54

  TOTAL 1062 28 22 50 1161 993 1.09

TO ACHIEVE THE NLEP GOAL FOLLOWING ACTIVITIES ARE BEING TAKEN UP DURING 2004-05

1. More emphasis on detection of new cases in high risk

blocks & prompt treatment with MDT

2. Completion of SAPEL Projects :

Total nos of SAPEL projects allotted. - 53

Total nos of SAPEL projects sanctioned. -

53

Total nos of SAPEL projects completed - 53

Total Population examined – 18, 76,742

Total New Case Detected – 633

MB-157, PB-476, Female Cases-186, Child Cases-32,

Deformity Cases-16

3. Completion of Balance POD Camps :

• Total 190 POD camps were planned. Out of which 172 POD

camps organized, where 583 leprosy patients & 1186 GHC

staff have been trained. POD to be completed in 2004-05 – 18.

4. INTEGRATION

Most of the general health staff has been trained.

MDT services being provided at all the health centers on all

working days.

Reverse integration of vertical staff is under process.

Simplified Information System is implemented. The analysis of the

SIS reports are being carried out at state level & corrective

actions are being taken up.

In the general health care system the un-trained MOs,

Pharmacist, HWs & newly appointed MOs will be given training

during 2004-05.

INTEGRATION (Continued)

1. Functional Integration• Training : Most of the GHS staff are trained & the 493 newly recruited MOs & remaining 1429 Paramedical are to be trained during 2004-05.• Availability of the SIS Format in all Health Facilities • Availability of MDT 100%

2. Organizational Integration

• Integration of vertical staff with GHS is under process

5. URBAN LEPROSY CONTROL PROGRAMME

Hiding attitude in urban population is a major problem in controlling the leprosy programme. Special efforts are to be taken for the same.The PR of the urban areas is 1.04/10000 as on March 2004.Following are few illustrative steps for elimination of leprosy in Urban Areas

• Identification of Govt./Semi Govt. & Private Health Facilities providing training to MOs & other related paramedical staff.• Distribution of MDT drugs through all such HFs.• Supply of SIS formats.• Involvement of NGOs.

6. IEC

Intensive IEC throughout the year & monitoring as per the checklist circulated. BLAC ( Block Leprosy Awareness Campaign ) – is being under taken in two blocks (Luxer & Narsan ) of district Haridwar which have PR more than 5. Total 53 leprosy Counseling Centers established, 26 new leprosy cases detected during BLAC.

7. Other ActivitiesMore emphasis on villages having leprosy cases, by concerning field staff:Follow up of leprosy cases for completion of treatments. Follow up of RFT cases.Constant watch on the new cases detected & their family members.Validation of new cases by DTST/Distt. Level officers.Proper record maintenance & cleaning of registers.

8. Monitoring of the programme & Management of MDT, Supply of SIS in urban area will be done by the nucleus team of the district.

Conclusion

We hope by effective implementation of all above activities the state will achieve the level of elimination i.e. PR < 1 by march 2005 positively.

Thanks.

Dr. S.R.S. Rana

SLO Uttranchal