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Disease Prevention and Control / Communicable Diseases / Leprosy

Reports from the Brazilian States: Leprosy Elimination Monitoring (LEM), 2003

Reports (in Portuguese, PDF averaging 21 pp, 609 KB)

Acre (AC)
Alagoas (AL)
Amapá (AP)
Amazonas (AM)
Bahia (BA)
Ceará (CE)
Distrito Federal (DF)
Espírito Santo (ES)
Goiás (GO)
Maranhão (MA)
Mato Grosso (MT)
Mato Grosso do Sul (MS)
Minas Gerais (MG)

Pará (PA)
Paraíba (PB)
Paraná (PR)
Pernambuco (PE)
Piauí (PI)
Rio de Janeiro (RJ)
Rio Grande do Norte (RN)
Rio Grande do Sul (RS)
Rondônia (RO)
Roraima (RR)
Santa Catarina (SC)
São Paulo (SP)
Sergipe (SE)
Tocantins (TO)

LEM Brasil 2003

LEM Report 2003 (nationwide)
LEM Guidelines for Monitors (WHO)

PAHO Leprosy Page
WHO Leprosy Page:
English   |   français

Leprosy Elimination Monitoring (LEM) is an independent formal evaluation with standard indicators developed by WHO for collecting data to complement routine information systems and to allow for greater detail with regard to health services, quality of care offers, and access to multidrug therapy (MDT) at the local, state, and national levels. These indicators can be used to measure specific aspects of actions undertaken for leprosy control, making information available to the actors involved in making decisions and implementing action plans.

As part of the process of cooperation between PAHO/WHO and the Ministry of Health of Brazil, a proposal was made to carry out LEM to increase the level of detailed knowledge available on the progress of leprosy elimination in the Brazilian states. In the northern and northeastern regions, the Alfredo da Matta Foundation was in charge of the LEM evaluation; and in the southeastern, southern, and midwestern regions, the Lauro de Souza Lima Institute. Both are PAHO/WHO Collaborating Centers for the National Program to Control and Eliminate Leprosy and WHO Collaborating Center for Leprosy Training, Research, and Field Activities.


LEM Key Indicators (standard indicators developed by WHO)

Group I: Elimination indicators

1. Case-finding activities

  1. Proportion of new cases with disabilities
  2. Average delay in diagnosis
  3. Proportion of children among new cases (or age-specific detection)
  4. Proportion of MB cases among new cases
  5. Proportion of single lesion among new cases
  6. Proportion of female among new cases (or sex-specific detection)

2. Prevalence: absolute numbers and rate

  1. Reported prevalence
  2. Prevalence after applying standard definitions (case, cure and defaulters)
  3. Prevalence trend over the last 5 years

3. Detection trend: absolute numbers and rate

  1. Detection trend over the last 5 years
  2. MB detection trend
  3. Child detection trend

Group II: Integration of MDT services within General Health Services

1. Proportion of existing health facilities providing MDT

2. Accessibility to MDT

  1. Average distance
  2. Estimated costs for the patients
  3. Flexibility in delivering MDT

3. Availability of MDT drugs

Group III: Quality of MDT services

1. Proportion of patients treated with MDT

2. Case-holding

  1. Cure rate
  2. Defaulter rate
  3. Defaulter rate

3. Quality of MDT blister-packs