NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP)  MAHARASHTRA STATE

 NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP)  MAHARASHTRA STATE

Introduction : Since 1955 National Leprosy Control Programme was being implemented on SET pattern (Survey, Education and Treatment) through vertical Infrastructure. In 1981-82 MDT was introduced in the State in phase wise manner, covering all the districts by 1995-96. MDT has yielded wonderful results in the form of reduction of P.R. from 62.40/10,000 (3,12,877 Balance Leprosy Cases under treatment) in 1981-82 to 14.70/10,000 (1,18,864 Cases) by end of 1991-92. In 1981-82 national leprosy control programme renamed as a national leprosy eradication programme. The decline in PR continued and PR during 2001-02 was 3.27/10,000 (32,318 Balance Leprosy Cases under treatment) and PR 1.19/10,000 (15347 Balance  Leprosy  Cases under treatment)  by end of February 2025.

NLEP is Centrally Sponsored programme. This programme is integrated in to General Health Care Service.  The NLEP is implemented in the State by Govt./ Local bodies (Zilla Parishad, Municipal Corporation and Municipal Councils) and Voluntary organizations. The State had achieved Leprosy elimination by end of Sep. 2005. (Elimination means to reduce the Prevalence Rate (PR) of the state less than 1 per 10000 populations)

Organogram :

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vision : Leprosy free India with zero infection and disease, zero disability, zero stigma and discrimination.

Goal : Accelerate towards achieving Interruption of Leprosy Transmission in India.

Specific objectives :

• Strengthen leadership, commitment, and partnerships
• Acceleration of Case Detection
• Provision of Quality Services
• Enhanced measures for Prevention of Disease, Disabilities, Stigma, Discrimination and Violation of Human Rights
• Digitalization of Surveillance Systems

 

Infrastructure  :

 

Sr. No.	Type of Institution	Institutions
1	Supervisory Urban Leprosy Units (SULU)	23
2	Urban Leprosy Centers (ULC)	237
3	Temporary Hospitalization Ward (Mumbai, Pune, Nagpur)	3
4	Govt. Lep. Dispensaries/ Kushtadham (Bandorwala Leprosy Hospital Pune,  Shendapark Kolhapur)	2
5	Reconstructive Surgery Units run by NGO	8
6	Leprosy Training Centers Govt. (LTC –Pune, Nagpur)	2
7	New NGO Scheme 2024-2025	5
7.1	NGO	11
7.2	Rehabilitation Services based NGO	16
7.3	Hospitals Services based NGO	13

 

 

 

 

 

Services rendered through NLEP:-

• MDT (Multi Drug Therepy) :-

1. After making a diagnosis of leprosy, one should group the patient based on certain characteristics. This is important because it help in selecting the correct combination of drug for given patient.

• Paucibacillary
• Multibacillary
• Grouping is done depending on number of skin lesions, nerves and smear positivity as follows

S.No	Characteristic	PB (Paucibacillary)	MB (Multi bacillary)
1	Skin lesions	1-5 lesions	More than 5 lesions
2	Peripheral nerve involvement	No nerve/only one nerve with or without 1 to 5 lesions	one or more nerve irrespective of number of skin lesions
3	Skin smear	Negative at all sites	Positive at any site
4	Treatment duration	6 months	12 months

 

• The treatment of leprosy for both PB & MB is in the form multi drug therapy (MDT), which is the combination of three of the following drug.

1. Rifampicin :-  10mg/kg body weight, monthly once
2. Clofazimine  :-  1 mg/kg body weight daily and 6mg/kg body weight, monthly once
3. Dapsone      :-  2mg/kg body weight daily

Note :- Since 1^st April 2025 the treatment regimen for PB is three drugs combination as of MB for the leprosy cases detected after 31^st March 2025.

• Disability Prevention & Medical Rehabilitation (DPMR)

1. Two pairs/Year of MCR footwear free of cost are provided to eligible Leprosy patients to avoid ulcer.
2. Goggles are supplied free of cost to eligible Leprosy patients of eye deformity.
3. Splints are provided free of cost to Hand Deformity patients for not to develop further deformity.
4. Ulcer Treatment are given free of cost to needy leprosy patients at PHCs, Dispensaries of Municipal Councils & Municipal Corporation, LRC and Self Settled Colonies.
5. Physiotherapy Services are given free of cost to needy leprosy patients having deformity or not to develop deformity at all Govt. Hospitals, LRC and Self Settled Colonies.

• RCS :-

1. Reconstructive Surgeries are performed on eligible deformed patients at General Hospitals and selected NGOs free of costs.
2. An incentive amounting to Rs.12,000/- is given to Leprosy Affected Persons for each Major Operation of Reconstructive Surgery (RCS).
3. Medical Colleges and District Hospital are also paid Rs.5000/- for each of the Major RCS conducted.
4. An incentive amounting to Rs.5,000/patient is given to those NGOs they performed more than 20 RCS.

LRC ( Leprosy Referral Centre) :-

 

• Total 277 LRCs established in Civil Hospitals/SDH/RH

Main objectives of LRC are :-

• To provide quality services, for diagnosis and management of leprosy and allied complications (lepra reaction & neuritis- disability threatening condition occurring during or after treatment) to persons affected leprosy.
• To provide quality preventive services for prevention of disability among persons affected with leprosy having risk for nerve damage.
• To provide quality care services for prevention of deterioration / worsening of deformity among persons affected leprosy living with disability.

 

• IEC :- With the help of print media, electronics media & Social media following key messages given to society

 

1. Sign & Symptoms of Leprosy
2. Type of leprosy
3. Stigma & discrimination
4. Type of treatment & availability of treatment
5. Treatment available at all Govt./Semi Govt. institute of free of cost
6. Availability of DPMR services
7. Benefits for volunteers, ASHA etc.

 

A ) Print Media :-		D )  Traditional Media :-
1	Poster	1	Wall Paintings Rally
2	Banner	2	Rally
3	Pamphlets	3	Exhibition
4	Diagnostic Cards	4	School Health Activity
5	Flip Chart
B ) Electronic Media :-		E) Other  Media :-
1	Radio zingals	1	Bricks Kiln/Construction sites/Mazoor Adda

 

• PEP (Post Exposure Prophylaxis) :-

 

• Inclusion Criteria of PEP :-

1. A person who has been living/working/having social activities for more than three months and 20 hours/week with a newly detected case of leprosy in a year.
2. Age > 2 years.

 

• Exclusion criteria of PEP :-

1. Pregnant women (PEP can be given after delivery).
2. People receiving Rifampicin for any reason in the last two years (e.g. for Tuberculosis (TB) or Leprosy or as a contact of index case of Leprosy).
3. People who have possible signs and/or symptoms of leprosy.
4. Person with acute febrile illness.
5. People with a history of liver disorders (ask for H/o jaundice, right sided abdominal pain and swelling, swelling in legs and ankles, pale colored stool).
6. People with a history of renal disorders (ask for H/o decreased urine output, swelling in legs and ankles, H/o high BP).
7. People who have possible signs and/or symptoms of TB (Patients having any of the these symptoms should be screened for TB: cough for more than two week, night sweats, unexplained fever, weight loss).
8. However, patients with signs and symptoms of other diseases including leprosy may be referred to nearest health facilities for further confirmation and management.

Physical Performance last 5 years :

S.N.	Indicators	2019-20	2020-21	2021-22	2022-23	2023-24	2024-25 (up to Feb. 2025)
1	New cases detected (NCD)	16531	12438	14520	19860	20001	18860
	ANCDR/ lakh*	13.07	9.55	11.14	15.58	15.54	15.36
2	Total Active Cases	10203	10417	11607	13088	14976	15347
	P.R./10,000	0.81	0.8	0.89	1.03	1.16	1.19
3	Child Cases among NCD	1360	922	1092	1301	1321	1015
	% of Child Cases among NCD	8.23	7.41	7.52	6.55	6.60	5.38
4	Gr.II Deformity Cases among NCD	258	160	141	184	138	118
	% Gr.II Deformity Cases among NCD	1.56	1.29	0.97	0.93	0.69	0.63
	Gr.II Deformity Cases per Million Population	2.04	1.23	1.08	1.44	1.07	0.92

* The ANCDR/Lakh rate has been calculated based on the number of new leprosy cases detected during last 12-month period from March 2024 to February 2025.

 

Leprosy Case Detection Campaign :-

This campaign started from 2015-16. In this activity with the help of ASHA and male volunteers, a door-to-door survey was conducted in 100 % rural areas and about 30 percent of the high-risk urban areas. This activity created a large-scale awareness about leprosy and succeeded in finding the hidden leprosy patients in the society in early stage and bringing them under MDT treatment. In the year 2024-25, this campaign was implemented in 20 high-risk districts of the state from 31st January to 15th February 2025 and in this campaign, 3826 new leprosy patients were detected and all of them were started on MDT treatment.

Year wise NCD cases in LCDC :-

Sr. No	Year	LCDC cases	Total cases	District Involved
1	2015-16	166	15695	5
2	2016-17	4134	15012	16
3	2017-18	5073	16065	22
4	2018-19	5268	15299	35
5	2019-20	6116	16531	35
6	2022-23	6731	19860	35
7	2023-24	6744	20001	35
8	2024-25 (up to Feb.2025)	3826	18860	20

 

Innovative activity – KuSuM  

Introduction of KuSuM :-

1. Government of India has given a clarion call to achieve zero leprosy transmission by 2027,three years ahead of SDG
2. To achieve zero leprosy transmission state need to first detect all hidden leprosy cases in the entire community
3. Active leprosy case detection need to be focused on marginalized groups viz brick kiln sites , migratory people, construction sites, residential schools for physically/mentally challenged students ,night shelters, mines , other industrial workers etc.
4. Most of the times marginalized groups go to work early in the morning and return home late in the evening and because of that they miss routine health check up and LCDC also
5. Right now there is no special activity for early detection of leprosy cases

from marginalized groups

6. Mapping of marginalized groups is completed
7. Screening of marginalized groups

Daily reporting, analysis of the data and feedback

• KuSuM (Kushthmukta Surakshit Maharashtra) 2023-24

SN	High Risk Areas	Total No	No of Enumeration	Physical examination	%	Suspects  identified	Suspect Examined	%	Total confirmed cases			Total G2D cases in NCD
									MB	PB	Total
1	Bricking sites	7460	224453	212984	95	2766	2766	100	128	230	358	1
2	Ashram School	1971	519029	476060	92	2847	2834	100	18	140	158	0
3	Migrated people	16164	406471	332064	82	2005	2003	100	55	80	135	2
4	Ashram School Hostel	983	180880	162683	85	779	779	100	4	47	51	0
5	Prisons	49	39333	35726	91	206	202	98	16	33	49	0
6	Mines	908	60910	57176	94	361	361	100	11	13	24	0
7	Other high risk places	3193	148103	126359	85	512	512	100	44	30	74	0
Maharashtra		30728	1579179	1403052	89	9476	9457	99.7	276	573 (67.5%)	849	3

• KuSuM (Kushthmukta Surakshit Maharashtra) 2024-25

SN	High Risk Areas	Total No	No of Enumeration	Physical examination	%	Suspects  identified	Suspect Examined	%	Total confirmed cases			Total G2D cases in NCD
									MB	PB	Total
1	Bricking sites	7303	261525	256402	98.0	5907	5836	98.8	96	195	291	0
2	Ashram School	1999	580643	570704	98.3	9369	9268	98.9	16	117	133	0
3	Migrated people	22050	600188	579157	96.5	7879	7650	97.1	133	200	333	2
4	Ashram School Hostel	1245	232119	207940	89.6	3241	3186	98.3	10	36	46	0
5	Prisons	49	40103	31713	79.1	368	368	100	13	31	44	0
6	Mines	964	55713	51570	92.6	1060	1060	100	8	17	25	0
7	Other high risk places	1375	201639	200477	99.4	3969	3880	97.8	59	91	150	0
Maharashtra		34985	1971930	1897963	96.2	31793	31248	98.3	335	687 (67.2)	1022	2

 

Beneficiary:

Citizens

Benefits:

As above