We are pleased to report on the collaborative session focused on accelerating the goal of leprosy elimination, titled “Leprosy: Interruption of Transmission and Elimination Roadmap”. This critical meeting was organized by the Department of Dermatology, JIPMER Karaikal, alongside Medical Officers from the Karaikal district, JIPMER Faculty, and Residents.
Event Details
The session took place on Tuesday, 12 November 2025, starting at 2:30 PM at the Academic Building, JIPMER Karaikal Campus.
Core Objectives and Burden
The programme reinforced the necessity of strengthening operational responses, particularly as India contributes nearly half of the global leprosy cases. While elimination has been achieved nationally in 2005 (prevalence rate <1/10,000 population), new cases continue to occur, indicating ongoing transmission.
The clinical and programmatic objectives highlighted during the session included:
- Strengthening early detection and diagnosis of leprosy.
- Promoting timely referral and disability reduction.
- Identifying cardinal signs confidently and differentiating leprosy from common mimickers.
- Recognizing reactional states and preventing disability.
Delay in detection leads to disability and deformity.
Inaugural Session and Key Addresses
The programme commenced with the Dhanvanthari prayer, followed by the inaugural address by Dr. Geethanjali S, Assistant Professor of Dermatology. This was followed by felicitation and remarks by dignitaries.
The session was presided over by Dr. Kusa Kumar Shaha, Dean, JIPMER Karaikal, who highlighted the current leprosy landscape in India, the goal of stigma reduction, and the path toward elimination. He actively engaged participants by posing questions on current epidemiological trends.
The event was further honored by:
Dr. R. Sivarajakumar, Deputy Director (Immunisation), Karaikal District – who emphasized the burden of leprosy and the need for continuous training of Medical Officers.
Dr. S. Kannaki, Medical Superintendent, Government General Hospital – who stressed the importance of strengthening case detection and reiterated that leprosy is a fully curable disease.
Scientific session
The session featured expert input on both the clinical and public health aspects of leprosy control:
| Speaker/Presenters | Affiliation | Topic |
| Dr Geethanjali S & Dr M Kalaiarasi | Department of Dermatology, JIPMER, Karaikal | Clinical diagnostic aspects of leprosy |
| Dr Preetam B Mahajan | Department of Preventive and Social Medicine, JIPMER, Karaikal | How to prepare for eliminating leprosy from the district and Union Territory? |
| Dr R Thenambigai | CMO, NFSG, District Programme Coordinator, Karaikal | Current leprosy situation in Karaikal: Operational response and challenges |
The programme concluded with the Vote of Thanks delivered by Dr. M. Kalaiarasi, Senior Resident, Department of Dermatology, followed by the National Anthem.
Participation
A total of 50 participants attended the event, including Medical Officers, JIPMER faculty, and interns.
Strategic Framework for Elimination
The roadmap focuses on achieving two key milestones, which are expressed in terms of incidence of new autochthonous cases:
- Interruption (Elimination) of Transmission: Defined as zero new autochthonous cases among children <15 years of age for at least 5 years.
- Elimination of Leprosy Disease: Defined as zero new autochthonous leprosy cases (any age) for at least three consecutive years.
Key tools discussed for monitoring this progress include the Leprosy Elimination Framework, the Leprosy Programme and Transmission Assessment (LPTA), the Leprosy Elimination Monitoring Tool, and the Leprosy Elimination Dossier.
Clinical Diagnostic and Management Highlights
Early diagnosis is paramount. A case of leprosy is identified by one or more of the following signs:
- Hypo-pigmented skin lesion with definite loss of sensation.
- Thickening or enlargement of a peripheral nerve (potentially leading to sensory loss, muscle weakness, or autonomic function disorders).
- Presence of acid-fast bacilli in a slit-skin smear.
Leprosy is classified based on the WHO system as either Paucibacillary (PB) (1–5 skin lesions, 1 nerve involved, slit skin smear negative) or Multibacillary (MB) (>5 lesions, >1 nerve involved, or slit skin smear positive).
Treatment utilizes Multi-Drug Therapy (MDT), which is based on WHO and NLEP guidelines:
- PB Regimen: Rifampicin once monthly plus Dapsone daily for 6 months.
- MB Regimen: Rifampicin and Clofazimine once monthly plus Dapsone and Clofazimine daily for 12 months.
The management of Leprosy Reactions is a critical emergency, as reactions are the main cause of nerve damage and disability. Type 1 (Reversal Reaction) and Type 2 (Erythema Nodosum Leprosum) require prompt management, often involving steroids like Prednisolone for Type 1, and Clofazimine or Thalidomide (for chronic, recurrent, resistant ENL) for Type 2.
Operational Response and Interventions in Karaikal
The operational strategy following the detection of a new case includes several sequential steps:
- Case Verification and Registration: Confirming the diagnosis and registering the case in the Nikusth software, which serves as a real-time, case-based digital database for tracking and monitoring.
- Contact Tracing and Screening: Preparing a complete list of contacts, including household members, neighboring households, and close social contacts. Field health workers then conduct house-to-house examinations.
- Contact Prophylaxis (SDR-PEP): Providing Single Dose Rifampicin (SDR) to all eligible close contacts after screening to reduce the risk of developing leprosy. Children under 2 years of age, pregnant women, and contacts with active TB are excluded from receiving SDR.
- Disability Prevention and Care: Assessing the index case for disability, teaching self-care practices, providing MCR footwear if needed, and ensuring timely referral for reactions.
- Community Awareness: Conducting health education to address myths (e.g., that leprosy is not curable or hereditary) and involving local leaders to reduce stigma. Awareness campaigns, such as the Sparsh Leprosy Awareness Campaign (SLAC), are vital for promoting awareness and encouraging early self-reporting.
Active Case Finding (ACF) is crucial to detect hidden cases early and interrupt transmission, targeting areas with recent cases, Grade-II disability cases, or child cases.
Conclusion and Key Messages
Successful elimination relies on a robust surveillance system, efficient diagnostics, appropriate treatment, and chemoprophylaxis for contacts. The Karaikal district aims to integrate leprosy services into general health services and focus on staff training and stigma reduction.
The overarching key messages emphasized for the community and health staff are:
- Leprosy is curable, and treatment is free.
- Think of leprosy in every hypopigmented patch.
- Reactions are emergencies; act early.
- Early detection prevents disability.
- One dose of Rifampicin (SDR) can protect contacts.
By focusing on these strategies and maintaining rigorous surveillance, the goal is to sustain elimination and eventually achieve zero new autochthonous cases