Leprosy overview in Ethiopia Location of Ethiopia Ethiopia N W 0.07 0 0.07 S 0.14 Miles E C ountry Profile - Population – 80 million Tigray Amhara - 84% - live in rural area # - Area – 1.2 Million Sq. Km # -Divided in to 9 Regions & 2 City Administrations # Afar # Benishangul Gumuz - 611 Woredas –comparable with districts - 15,000 Kebeles (5,000 Urban and 10,000 rural Gambella Dire awa Addis Ababa HARER Oromiya Somali SNNPR N W E S Ethiopia leprosy situation • Leprosy services fully integrated into the general health services • Leprosy is part of the 5 years strategic plan for TB, Leprosy, TB/HIV and MDR-TB prevention and control (2010 – 2014) • Mission: Reduce morbidity, mortality and disability from TB and Leprosy through implementation of promotive, preventive, curative and rehabilitative health and related services in collaboration with all stakeholders. Objectives of TB Leprosy Control • Leprosy: Reduce the proportion of disability grade-2 among new leprosy patients to less than 10% Ethiopia leprosy situation • MDT treatment is made available by WHO free of charge and GLRA is the main partner supporting • Leprosy prevalence at the end of 2009: 4,942 (0.6 per 10,000 population) • Proportion of MB = 91% • Children: 7 % • Grade 2 disability rate: 7 % • Treatment completion rate: – MB leprosy - 94% – PB leprosy - 97% Ethiopia Leprosy Case Notification: 2000-2009 Year New cases Child rate % Grade II disability (%) MB (%) 2000 4,732 6 13 81 2001 4,584 7 13 84 2002 4,940 6 15 86 2003 5,193 6 15 88 2004 4,787 7 14 88 2005 4,698 7 13 88 2006 4,092 8 11 75 2007 4,187 7 10 93 2008 4,414 7 9 91 2009 4,302 7 7 91 Ethiopia Leprosy Case finding by regions 2009 Regions Total (New and Retreatment) Leprosy Cases PB Tigray MB New cases Tot. PB MB % New: 0 -14 yrs Tot. PB MB Tot. New (Gr: 2) % PB MB Tot. % 5 68 73 5 61 92 66 0 6 6 9 0 15 15 23 14 23 37 14 15 52 29 2 5 7 24 1 2 3 10 Amhara 122 1,417 1,539 118 1,275 92 1,393 12 52 64 5 2 88 90 6 Oromiya 171 2,311 2,482 156 2,045 93 2,201 18 147 165 7 5 101 106 5 1 16 17 1 14 93 15 0 1 1 7 0 3 3 20 Benshangu l 14 44 58 14 44 76 58 2 6 8 14 0 8 8 14 SNNPR 66 271 337 60 220 79 280 6 26 32 11 5 28 33 12 Gambella 3 37 40 3 28 90 31 0 0 0 0 0 5 5 16 Hareri 0 9 9 0 9 100 9 0 0 0 0 0 1 1 11 Addis Ababa 7 84 91 7 78 92 85 0 2 2 2 0 13 13 15 Dire Dawa 1 7 17 1 6 38 16 0 0 0 0 0 0 0 0 Other Hospitals 5 154 159 5 114 96 119 0 2 2 2 19 6 25 21 National 409 4,441 4,859 384 3,909 91 4,302 40 247 287 7 32 270 302 7 Afar Somali Remark: Completion rate of MDT is calculated based on the evaluated case reported in 2001, not based on the case finding during the cohort period is 98 % of the cases are completed their treatment. That is because there are cases that were not reported during the cohort Ethiopia Leprosy Prevalence Rate at the end of 2000EFY TIGRAY Leprosy Prev rate 0 - 0.2 0.3 - 0.5 0.6 - 0.8 0.9 - 1.5 1.5 - 3.4 0.3 AFAR 0.1 AMHARA 0.9 BENISHANGUL-GUM 0.6 DIRE DAW A 0.5 HARARI 1.5 AA 0.5 GAMBELLA OROMIA 3.4 SNNPR 0.2 0.8 SOMALLI 0.0 N W E S Leprosy treatment outcome by regions Regions Tigray Afar Amhara Oromiya Somali Benshan gul SNNPR Class ificati on Regis tered MB Treatment completion Evaluated No % No % Died No Transfer out Default % No % No % MB 79 60 76 52 66 3 4 2 3 3 4 PB 3 5 167 5 167 0 0 0 0 0 0 MB 13 24 185 24 185 0 0 0 0 0 0 PB 2 5 250 5 250 0 0 0 0 0 0 100 1,091 86 10 1 76 6 82 6 111 96 98 1 1 11 11 1 1 113 1,918 98 11 1 157 8 119 6 MB PB MB 1,265 1,259 98 109 1,955 2,205 PB 132 155 117 143 108 1 1 6 5 5 4 MB 18 5 28 5 28 0 0 0 0 0 0 PB 2 0 0 0 0 0 0 0 0 0 0 MB 75 52 69 43 57 1 1 5 7 3 4 PB 13 1 1 0 0 0 0 0 0 0 0 MB 294 349 119 289 98 9 3 32 11 19 6 PB 34 59 174 53 156 2 6 2 6 2 6 Challenges • Low skill of health workers to diagnose and manage leprosy • Low partner support and lack of fund for Leprosy (neglected) Thank you!