Malintad, Abdurrahim V.

BSN 2-B
Kanuntis, Hanouf Community Health in Nursing

National Leprosy Control Program

Description
• The National Leprosy Control Program (NLCP) is a multi-agency effort to control Leprosy
in the country with private and public partnership in achieving its goals to lessen the burden
of the disease and its mission to have a leprosy-free country.
Vision
• Leprosy-free Philippines by the year 2022.
Mission
• To ensure the provision of comprehensive, integrated quality leprosy services at all levels
of healthcare.
Objectives
• To further reduce the disease burden and sustain provision of high-quality leprosy services
for all affected communities ensuring that the principle of equity and social justice are
followed.
• To decrease by 50% the identified hyper endemic cities and municipalities.
WHAT IS LEPROSY?
Is an infectious disease that cause severe, disfiguring skin sores and nerve damage in the arms,
legs, and skin areas around the body. The disease has been around since ancient times, often
surrounded by terrifying, negative stigmas and tales of leprosy patients being shunned as outcast.
Infectious agent- mycobacterium leprae an acid fast, rod shaped bacillus which can be detected by
slit skin smear or SSS.
EARLY SIGNS AND SYMPTOMS
• Change in skin color
• Loss of the skin sensation on the skin lesion
• Decrease/loss of sweating and hair growth over the lesion
• Thickened and/ or painful nerves
• Muscle weakness or paralysis of extremities
• Pain and redness of the eyes
 • Nasal obstruction or bleeding
• Ulcers that do not heal
LATE SIGNS AND SYMPTOMS
• Madarosis- loss of eyebrows
• Lagophthalmos- inability to close eyelids
• Clawing of fingers and toes
• Contractures
• Sinking of the nose bridge
• Gynecomastia
• Chronic ulcers
CLASSIFICATION OF LEPROSY
• Paucibacillary (PB) (tubercoloid and indeterminate) Non- infectious. Tx 6-9 months
• Multibacillary (MB) (lepromatous and borderline) infectious. Tx 24-30 months
Method of transmission
• Prolonged skin-to-skin contact
• Droplet infection
Susceptibility
• Children especially 12 years and below are more susceptible
Prevention
• Avoidance of prolonged skin-to-skin contact especially with a lepromatous case
• Children should avoid close contact with active, untreated leprosy case
• Bacille Calmette- Guerin vaccination
• Good personal hygiene
• Health education
Management/ Treatment
 Ambulatory chemo therapy through use of multi-drug therapy
• Domiciliary treatment as embodied in R.A. 4073 which advocates home treatment
In view of recent advances in the treatment of leprosy, the following are the standard mode of
treatment for leprosy cases.
All Paucibacillary leprosy cases shall be treated with the PB regimen as follows
Drugs/duration Adult Child (10-14 years)

Rifampicin 600 mg once a month 450 mg once a month

Dapsone 100 mg daily 50 mg daily

Duration of Treatment 6 blister packs should be 6 blister packs should be

taken monthly within a taken monthly within a
maximum period of 9 months maximum period of 9 months

 Adjust dose appropriately for children less than 10 years. For example, rifampicin 300
mg and dapsone 25 mg.
 Patients with single skin lesion and a negative SSS may be treated with single dose of the
ROM regimen as follows.
Single dose ROM Adult Child (10-14 years)

Rifampicin 600 mg 300 mg

Ofloxacin 400 mg 200 mg

Minocycline 100 mg 50 mg

All Multibacillary leprosy cases shall be treated with the MB regimen as follows
Drugs/ duration Adult Child (10-14 years)
Rifampicin 600 mg once a month 450 mg once a month
Clofazimine 300 mg once a month and 50 150 mg once a month and 50
mg daily mg every other week
Dapsone 100 mg daily 50 mg daily
Duration of Treatment 12 blister packs to be taken 12 blister packs to be taken
monthly within maximum monthly within maximum
period of 18 months. period of 18 months.
 • Adjust dose appropriately for children less than 10 years. For example, rifampicin 300 mg,
dapsone 25 mg, and clofazimine 100 mg once a month and 50 mg twice a week.
• Should be patient fail to complete treatment within the prescribed duration, then said
patient should continue treatment until he/she has consumed 24 MB blister packs
Completion of treatment
All patients who have compiled with the above mentioned treatment protocols are considered
cured and no longer regarded as a case of leprosy, even if some sequelae of leprosy remain.
Policies and Laws
• Administrative Order No. 167, s. 1965: Rules and Regulations of Leprosy Control in the
Philippines
• Republic Act No. 4073: An Act further liberalizing the treatment of leprosy by amending
and repealing certain sections of the revised Administrative Code
• Presidential Decree No. 384 January 30, 1974: Amending Republic Act No. 4073 entitled
An Act further liberalizing the treatment of leprosy by amending and repealing certain
sections of the revised Administrative Code
• Proclamation No. 467: Declaring the Last Week of February of every year as Leprosy
Week
• Administrative Order No. 26 – A, s. 1997: Guidelines on Elimination of Leprosy as Public
Health Problem
• Administrative Order No. 5, s. 2000: Guidelines on the integration of leprosy services in
hospitals
• Department memorandum No. 79, s. 2004: Recommendations to pursue Leprosy
Elimination Activities in all areas in the country
• Department Circular 366-B, s. 2003: First Leprosy Forum of the Philippine Dermatological
Society on November 12, 2003
• Department Circular 254, s. 2004: Second Leprosy Forum of the Philippine Dermatological
Society on November 9, 2004
Program Components
• Early diagnosis and treatment
• Integration of leprosy services
• Referral system
• Case detection and diagnosis
• Advocacy and IEC focusing on stigma discrimination and reduction
 • Prevention of Deformity, self-care and rehabilitation
• Recording and reporting
• Monitoring, supervision and evaluation
Strategies, Action points and Timeline
Strengthen local government ownership, coordination and partnership
• Ensuring political commitment and adequate resources for leprosy programs at all levels
• Contributing to UHC with a special focus on children, women and underserved populations
including migrants and displaced people.
• Promoting partnerships with state and non-state actors and promote inter-sectoral
collaboration and partnerships at the international, national and sub-national level
• Facilitating and conducting basic and operational research in all aspects of leprosy and
maximize the evidence base to inform policies, strategies and activities.
• Strengthening surveillance and health information systems for program monitoring and
evaluation (including geographical information systems)
Stop leprosy and its complications
• Strengthening patient education and community awareness on leprosy.
• Promoting early case detection through active case-finding (e.g. campaigns) in areas of
higher endemicity and contact management.
• Ensuring prompt start and adherence to treatment, including working towards improved
treatment regimens
• Improving and management of disabilities.
• Strengthening surveillance for antimicrobial resistance including laboratory network.
• Promoting innovative approaches for training, referrals and sustaining expertise in leprosy
such e-Health (LEARNS)
• Promoting interventions for the prevention of infection and disease. –Chemoprophylaxis
Stop discrimination and promote inclusion
• Promoting societal inclusion through addressing all forms of discrimination and stigma
• Empowering persons affected by leprosy and strengthen their capacity to participate
actively in leprosy services. -CLAP
• Involving communities in actions for improvement of leprosy services.
 • Promoting coalition-building among persons affected by leprosy and encourage the
integration of these coalitions and or their members with other CBO’s.
• Promoting access to social and financial support services, e.g. to facilitate income
generation, for persons affected by leprosy and their families.
• Supporting community-based rehabilitation for people with leprosy related disabilities
Program Accomplishments/Status
Indicator 2017

Prevalence rate of <1 per 10,000 population 0.4

MB/PB (new cases) 1660/249

Children below 15 years old & proportion 6.7%

The National Leprosy Control Program in coordination with the Research Institute for Tropical
Medicine (RITM) has started the National Leprosy Baseline Survey this year (2018) and expected
to be completed in 2019. This will help the program in prioritizing augmentation in areas with high
prevalence rate. This will also give a real picture of the country’s status in maintaining the
elimination level of leprosy cases.
Continuous support has been given to all new MB and PB cases through provision of supportive
drugs from the NLCP and Multidrug Therapy (MDT) from World Health Organization (WHO).

Calendar of Activities
• World Leprosy Day (Every last Sunday of January)
• Leprosy Control Week (Every 4th week of February)
• National Skin Disease Detection and Prevention Week (Every 2nd week of November)
Statistics