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Volume - 78, Issue - 1

other
Pages 5 - 6
Original Papers
Pages 7 - 10
  • Community dermatology inclusive of leprosy: its past present and future

    • Terence J. Ryan
    Volume 78, Issue 1

    | Published on March 2007

    The archives of leprosy and its global history are currently evolving in Oxford. A collection of documents and books are housed in the historical library of Sir William Osler under the heading of ‘Public Health before and after Osler’ and the history of leprosy can be found on http://www.leprosyhistory.org. A striking feature of the old books is their attention to the designation ‘Lepra’ and the evolution of not just leprosy but of the other differential diagnoses of the eighteenth and nineteenth century such as psoriasis.. Even in the twentieth century, the development of a major interest in Oxford led by Weddell was the innervation of the skin first in psoriasis and then in leprosy, joint meetings with Weddell, Cochrane, Browne, Rees and others over patients with leprosy, to the building of the Cochrane Annex and the work of Colin MacDougal in the Department of Dermatology.

Original Papers
Pages 11 - 16
  • A public health approach for leprosy detection based on a very short term-training of primary health care workers in basic dermatology

    • O. Faye
    • R. J. Hay
    • T. J. Ryan
    • S. Keita
    • A. K. Traoré
    • A. Mahé
    Volume 78, Issue 1

    | Published on March 2007

    Introduction

    In countries where leprosy control is integrated to general heath services, health workers, at primary health care level, often manage a large number of patients with skin diseases including leprosy. The distinction of leprosy from others skin diseases requires more skill and attention. Basic dermatological knowledge will help these staff to provide a better quality of care. A few years ago, a short term training programme focussed on leprosy and some common skin diseases was set up in Mali through a pilot project. This study will evaluate the impact of this training on the detection of leprosy at primary health care level.

    Methods

    health care workers from two health districts were invited to participate in the training. Trainee was submitted to an anonymous written test before training, immediately after and 12–18 months post-training using a standardized scoring system. The suspected or referred leprosy cases before and after training were compared. Data were recorded and analysed with the software Epi info version 6.04.

    Results

    Overall, 495 HCW attended the three anonymous written tests (before training, just after and 12–18 months later). The proportion of participants who gave correct answers before training, just after were respectively: 33 and 57% for correct diagnosis, 5 and 39% for test of sensation and 28 and 47% for referral. Eight patients suspected of leprosy were referred for further examination; in these, five cases of leprosy were detected.

    Discussion

    The training showed a huge improvement in the skill of the participants in managing leprosy patients. This study addresses how leprosy control can be improved by involving primary health care staff and by the implementation of only a single days training on basic dermatology.

    Conclusion

    The role of the dermatologist in this post- elimination era of leprosy needs to be reconsidered and adapted to the increasing need to take multiple programmes, inclusive of dermatology and leprosy, into primary health care services and those interested in leprosy control should fund these programmes.

Original Papers
Pages 17 - 21
Original Papers
Pages 22 - 25
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