What do we want to monitor about early case detection?：
It is the early part of it, using indirect indicators like：
a) Proportion of disabled among newly diagnosed cases. (also measured in some programmes as the impairment status of newly detected cases)
Cases which are detected early enough should have no impairments or disabilities.
b) The age of new cases. (Detection of children below the age of 15 years).
This does not necessarily measure "early detection" but it at least suggests that the cases detected at the early age, in the absence of an efficient detection mechanism could have been missed until they would present with "late" leprosy as adults.
A shift to detection at older ages combined with increased disability might point to longer delays in detection. (22)
c) The results of PCR technology, which has the potential for tracking transmission and the incidence of infection and disease. (21, 25)
d) Others.
Whatever the choices will be, it is important to consider the recommendation that future monitoring of new case detection should be based on standardised case detection methods and consistent diagnostic criteria over many years (24) .
6. HOW CAN EARLY CASE DETECTION BE IMPROVED?
We need to establish more clearly what is on the ground (within the context of the established concepts of active and passive case detection) in order to identify areas of improvement.
What is being practiced：
i) Health Education (promotion) to various target groups to stimulate voluntary reporting of cases. (26, 27)
ii) Surveillance/Surveys - Chase surveys (propaganda treat. surveys) in Indonesia (28)
- School surveys
- Contact surveillance
- Surveys in old leprosy villages (29)
iii) Combining programmes in order to "sustain the leprosy eye". (30, 31)
iv) Case detection components of Leprosy Elimination Campaigns (LEC), and Special Action Projects for Elimination of Leprosy (SAPEL).
v) Integration into Primary Health Care (PHO, (32, 33)
Selection of areas of improvement：
The areas of improvement should be selected：
a) according to the priorities of the interested parties： PERSONS AFFECTED BY LEPROSY (BENEFICIARIES) - THE ONE TO BE DETECTED. THE HEALTH PROVIDER, THE PUBLIC including fund raisers, by studying the present role of each one. (34)
