April 13th2023 (CPA). – – The epidemiological situation of leprosy in the Democratic Republic of Congo (DRC) was discussed on Wednesday by the director of the National Programme for the Elimination of Leprosy (PNEL), Dr. Florent Ngondu, in an exclusive interview with CPA.
Leprosy is a chronic infectious disease caused by a bacterium called « Mycobacterium leprae ». The disease mainly affects the skin, nerves, limbs and eyes. Early treatment can prevent the after-effects of the disease.
Question1: Mr. Director of the National Leprosy Elimination Programme, can you give us an overview of the epidemiological situation of leprosy in DRC and the provinces most affected?
Dr Florent Ngondu: In 2021, our country detected 4,148 (four thousand one hundred and forty-eight) cases of leprosy. Among these cases, more than 10% are children and also more than 10% have visible disabilities. When we interpret these two indicators, it means that there are still active outbreaks in our provinces and that screening is done late, because there are visible disabilities.
As far as the most affected provinces are concerned, it should be said that leprosy is everywhere in DRC, but to varying degrees. We have 11 provinces with a large number of patients. More than 50% of new cases come from 11 provinces, namely Tanganyika, Tshopo, Tshuapa, Haut-Katanga, Haut-Uele, Bas-Uele, Equateur, Mai-Ndombe, Sankuru, Nord-Ubangi and Kasaï. But in the other provinces, there are indeed cases of leprosy. Question 2: What are the difficulties that hinder the fight against leprosy, the functioning of the programme and the management of this disease?
Dr Florent Ngondu: We have many difficulties. The biggest difficulty is related to the financing of this fight, which is very much turned towards the outside, that is to say, it is the international NGOs that support the fight against leprosy in DRC. The government gives us salaries and bonuses, but we want it to make a lot more effort in investment so that we can support the provinces that are still endemic. This will enable us to reach the deadlines that await us, especially in 2030, the year in which we must achieve zero cases of leprosy, zero disabilities, and zero stigma.
We really need the means to achieve this because we have pockets of patients who are hidden. We must, with the necessary means, go and find the patients to treat them because we have the medicines. We give medicines free of charge to all the patients and there are patients who are missing. We, i.e. the community and the health workers, must combine efforts so that we can move forward.
Question 3: What are the challenges and prospects for ending leprosy as a public health problem in DRC?
Dr Florent Ngondu: Speaking of prospects, we want to reduce the extent of leprosy at the peripheral level, i.e. at the level of health zones and health areas that are still endemic, by conducting non-routine leprosy elimination campaigns. We also want to look for pockets of hidden patients and also examine their contacts, i.e. around each new case we also want to examine his entourage, and if we can find a new patient, we treat him and then we move on.
We are looking to mobilise funds to support our strategic plan so that we can achieve the goals we have set for ourselves.
Regarding the challenges, the scary thing about leprosy is the visible disabilities. We want to prevent these disabilities and also to see how we can physically adapt those patients who have disabilities, first of all through early detection. Through early detection, the person can know the disease from which he or she suffers. We have to pass on the message to the community that a light stain on the skin is a reason for medical consultation. At the health centre, they will examine you, and if it is leprosy, they will give you medication and you will be cured.
In short, leprosy still exists in DRC, which is among the countries with a high burden of the disease. A mobilisation of all is necessary, that is to say the government, the partners who support us, the health workers and the community, we must put ourselves together so that we can arrive at zero cases of leprosy, zero disabilities and zero stigmatisation.
We have 26 provinces, but there are 27 coordinations that deal with leprosy and tuberculosis because Kongo Central has two coordinations. CPA/