Long-term follow-up of families in an endemic area.

Gandhi Memorial Leprosy Foundation started its leprosy control work around Sevagram village in Wardha District (State of Maharashtra) in 1952. Long-term followup records of families of twenty-seven villages in this area were analyzed to assess the leprosy profile. In this paper, the data on household contacts followed from 1952 to 1986 are presented. This study is based on 6284 healthy contacts of 1184 primary cases detected during the period 1952 to 1984. Of the 1184 primary cases, 242 were detected initially in 1952, the starting year of leprosy control work in the Sevagram leprosy control unit. The total attack rate among household contacts of all types of leprosy was 4.46 per 1000 person years of risk (PYR). In contacts of L/BL/BB types of leprosy (corresponding to present day multibacillary) cases it was 9.86 per 1000 PYR; and in contacts of 'N' type of cases (corresponding to present day paucibacillary leprosy) it was 3.9 per 1000 PYR. Amongst non-exposed population, the rate was 1.98 per 1000 PYR. Attack rate was found to be increasing with BI of primary cases but it was not influenced by regularity of treatment of primary cases. Taking family as a unit, the risk of developing cases or additional cases of leprosy was similar in 'no-case' families and 'case families'.