Phl accounts for big number of leprosy cases in W. Pacific

CORON, Palawan, Philippines – For six years since 2006, the Philippines has been the leading contributor in leprosy cases in the Western Pacific region, experts said here yesterday.

Dr. Belen Dofitas, vice president of the board of trustees of the non-governmental organization Philippine Leprosy Mission, said China is “even second” to the Philippines in leprosy cases despite its population of more than one billion.

But Dofitas was quick to clarify that this may be attributed to the Philippines’ good surveillance system for leprosy, known as Hansenite disease.

“Maybe we really have more cases than the other countries but, of course, the other factor is maybe we are more active in finding cases…  That could also explain because new cases, as an indicator, are dependent on how much effort is being put into detecting cases,” she said during a strategy planning meeting here organized by pharmaceutical giant Novartis.

Since 2000, Novartis has been providing all leprosy patients in the world with two of the three drugs in the multi-drug therapy (MDT) — rifampicin and clofazimine — through the World Health Organization (WHO) free of charge.

Dofitas said the fact that it could take even up to 20 years for leprosy symptoms to manifest is also hampering the campaign. “Even if there’s multi-drug therapy, researchers have noticed the decline in the number of new cases is not dramatic.”

Citing records of the WHO, Dofitas reported that in 2011, there were 1,818 new cases in the Philippines, representing 36 percent of the cases detected in Western Pacific.

Based on the “Leprosy Control And The Burden Of Leprosy in The Philippines: 2006-2010” report of a multi-sector Technical Working Group (TWG), the country reported 47.14 percent of total leprosy cases in the region.

“In the next years, 2007-2010, the percentage of new multibacillary cases were 38 percent, 44.3 percent, 40.1 percent and 46.2 percent respectively,” according to the report.

The report also shows that while the Philippines accounts for 40.4 percent of cases in the Western Pacific, China accounts for 26.2 percent of cases.

Known as a Biblical disease, leprosy is a disease of the skin and the nerves caused by Mycobacterium leprae.

Decades ago, a person with leprosy was usually sent to a leprosarium as the illness was highly infectious and incurable then.

Dofitas said that while leprosy has long been curable, the deformities or the physical damages that it is causing the patients has made the disease “stigmatizing.” This results in the patients being turned away by the community although they are already cured.

According to Health Assistant Secretary Pauline Ubial, the Philippines eliminated leprosy as a “public health problem” in 1998 but the country must introduce some “innovations” in its leprosy control program to prevent the illness from re-emerging.

“We have strategies to maintain the elimination stage. But after 2010, there were proposals to have new strategies for the next 10 years on how to deal with the post-elimination stage,” she told The STAR.

Ubial admitted that the Department of Health’s “Kilatis Kutis” campaign needs to be supported by other strategies to effectively fight off leprosy.

Designed to achieve WHO’s elimination goal of having only one case per 10,000 population, the program focuses on detecting cases by urging the public to see a doctor when they develop any skin problem.

“We should have other strategies for the post-elimination. We think you have to focus now on hyper-endemic areas. It should not be a uniform program for all areas,” she added.

Ubial gave assurance that while the Philippines still maintains the elimination level set by WHO, there are “pockets of cases” in some areas that contribute to the country’s high number of new cases.

The TWG report identifies these areas as Ilocos Sur (Candon City, San Juan, Tagudin), Tarlac (Tarlac City), Nueva Ecija (Lupao), Metro Manila, Cebu (Cebu City), Davao del Sur (Davao City), South Cotabato (General Santos City), Basilan (Lamitan City), and Lanao del Sur (Marawi City).

These areas posted a prevalence rate of between 1.0 to 1.9 per 10,000 in 2010.