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  1. Saman B. Gunatilake*,
  2. Sunil Settinayake
  1. *Department of Medicine, Faculty of Medicine, University of Kelaniya, PO Box 6 Thalagolla Road, Ragama, Sri Lanka;
  2. Director, National Leprosy Control Programme, Room 21, National Hospital, Colombo, Sri Lanka. E-mail: samanbg{at}



Leprosy is a communicable disease due to chronic infection caused by Mycobacterium leprae, principally affecting the skin and peripheral nerves. It does not affect the spinal cord or brain in man. It is still one of the major health problems of developing countries.

Case diagnosis and detection are not always clear or consistent, and reporting in many parts of the world is incomplete or irregular. Indeed, because of the fear, shame and social stigma associated with the disease, leprosy is generally under-reported. However, simplified WHO diagnostic criteria along with community awareness programmes have helped in reducing social stigma and improving case detection. The WHO estimated there were 10–12 million cases in the 1980s. The latest estimate (1994) is 2.4 million cases, a reduction of over three-quarters, mainly due to the widespread use of multidrug therapy in leprosy control (WHO 1994). According to the WHO, 543 662 new cases

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