Under Leprosy Case Detection Campaign (LCDC) of the National Leprosy Eradication Programme (NLEP), funded jointly by the Centre and the State government, all people from Scheduled Caste (SC) communities across Bihar’s 38 districts were surveyed for leprosy detection between January 9 and 13 this year.

The survey result will be published in the first week of February. Sampling of collections and initial reports suggest nearly 50,000 new leprosy cases, according to Dr Bijoy Kumar Pandey, Additional Director (Headquarters), Health Services, and State Programme Officer for leprosy.

This could represent an all-time high detection of new leprosy cases in the state.

Dr Pandey, who plans to survey the entire population of the state in the next financial year, stated that this is a projected figure based on initial findings of the survey.

Leprosy cases in Bihar had a prevalence rate of 0.79 (cases per 10,000 people) in 2015-16 with detection of 16,185 new cases. In 2016-17, the prevalence rate increased to 1.10 with 21,818 cases, and to 1.18 with 21,353 new cases in 2017-18.

This rise can be attributed to several factors including unhygienic living conditions, too many people living in one room and sharing the bed, and a more active search and increased level of awareness, among others.

The percentage of children among the cases detected across Bihar was 14.20 in 2015-16, 13.70 in 2016-17, and 12.56 in 2017-18.

Dr RK Singh, who has attended to several leprosy patients in Hajipur district, said that an obvious reason for the rising leprosy cases in Bihar is the lack of single-dose rifampicin (SDR) programme for people living in close contact of an affected patient. Lack of sanitation and general awareness of hygiene are other reasons.

An official associated with NLEP mentioned that lack of infrastructure is also an obstacle in the way of monitoring cases. In some districts, such as Gopalganj, there is no NLEP staff. One non-medical staff has to look after several primary health centres (PHCs). Posts of leprosy consultant and physiotherapist remain vacant. Very few vacancies, out of the sanctioned 434 paramedical workers, have been filled. They have to depend on ASHA workers and other volunteers and get technical assistance from four NGOs - NLR India, The Leprosy Mission, DFIT and Lepra Society.

Dr Pandey said that it should not be referred to as a rise in the number of cases. He mentioned that the increased numbers are due to the active search undertaken by the sustained campaign, especially after launch of LCDC in 2015-16.

When asked why cases are increasing despite a sustained NLEP, Dr Pandey said that possibly, 20 per cent population was not covered under the previous survey and that the people not covered could have been from SC communities.

Dr Pandey’s predecessor, Yanteshwar Jha; however, denied it. He said that during his tenure as SPO, door-to-door search was conducted and they visited SC households. He added that the level of awareness has gone up now, but cases were duly detected during his tenure from 2011 to 2014.

Jha added that this period showed a prevalence rate of 0.89-1.2.