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A ProMED Mail Post Via: Pacific Public Health Surveillance Network January 16, 1998

As someone who had started the National Leprosy Elimination Programme in Papua New Guinea (PNG), I thought I would make a few comments on the status of leprosy in the North Solomons Province of PNG. I should say leprosy control in the rest of the country is a success story yet to be told to most disease control people in the region.

With support from the Sasakawa Memorial Health Foundation, The Leprosy Mission, and the World Health Organisation, the Department of Health has succeeded in reducing the incidence and prevalence of leprosy in all the provinces in PNG except the North Solomons Province. Updates of the Programme can be sought from the National Department of Health in PNG.

The problems of the Province are not acute and therefore I find it difficult to believe that it is an outbreak. The problem is lack of multi-drug therapy treatment availability and case review and registration, as had been done throughout the rest of the country. What is needed on the island of Bougainville and North Solomons Province is re-establishment of a well-coordinated disease surveillance and control section. I am afraid that following the long absence of government services there is likely to be an increase in prevalence of most chronic notable infectious diseases like yaws and tuberculosis. I would not be surprised if one discovers a locally circulating polio virus. At least this was one of our major concerns when we had discussions regarding the classification of PNG as a polio free country.

I therefore believe this should not be regarded as an outbreak but rather a hyperendemic state of leprosy resulting from lack of government services and accessibility to available treatment and control measures.

However, I do believe it should be treated like an epidemic.

--Dr. Clement Malau, Manager, Community Health Programme South Pacific Commission E-mail: ClementM@SPC.ORG.NC

[We are grateful for this rapid and detailed reply from Dr. Malau.

Yvan Souares informed us that Dr. Malau is from PNG and has been working for many years as the head of the Communicable Diseases Control Programme at the PNG Ministry of Health.


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