4. POID after chemotherapy：
In addition to comments made under 3, the following points were made：
Patients need to receive adequate health education so that they are empowered to understand when and where to request care if complications due to leprosy arise after they are released from treatment with chemotherapy.
For high risk patients (e.g. those with initial high bacterial load) , it is recommended to organize adequate follow-up after completing chemotherapy in order to recognize and treat nerve function impairment and leprosy reactions in time.
5. Management of people with established nerve function impairment and/or disability：
People with lasting complications due to leprosy in the form of eye problems, ulcers, muscle paralysis, etc., should receive continued care. This is preferably provided at community level (community based rehabilitation) , but referral for specialist care should also be available.
6. Alliances and partnerships：
It is preferable that people with secondary complications due to leprosy are treated in general medical facilities whenever possible. Eye problems, for instance, can usually be dealt with adequately in general eye units or services.
Reverse integration is also possible, where leprosy treatment centres provide specialist care for non-leprosy patients. Examples of this principle are ulcer care for diabetic patients, and hand therapy for trauma victims.
Education about leprosy and leprosy complications should filter into general medical services at all levels in order to facilitate integration and partnerships.
J. Richardus Erasmus University Rotterdam, Rottrerdam, THE NETHERLANDS
