title: Leprosy affected beggars as a hidden source for transmission of leprosy.
abstract: OBJECTIVE
  Despite the large scale implementation of multidrug therapy (MDT), the incidence rates of leprosy have not declined in several hyperendemic countries. Before searching for non-human reservoirs of leprosy it would be necessary to look for hidden human sources. This would include destitute leprosy affected persons who resort to begging and operate in congested areas. Hence this study was undertaken.
  
  
  METHODS
  One major town and three semi-urban areas in Vellore district of Tamil Nadu and Chittoor town in Andhra Pradesh were purposefully selected for the study. All beggars in these towns were systematically identified and examined by allopathic doctors. Skin smears were examined for bacteriological index.
  
  
  RESULTS
  Among the 193 beggars screened, 58 had leprosy. Of these 10 were smear positive. Several beggars, although living separately, were in touch with their relatives. Most beggars were pavement dwellers and regularly begged at places of worship, bus stands and shopping centres.
  
  
  CONCLUSIONS
  The fact that nearly 20 per cent of the leprosy affected beggars were skin smear positive highlights the need for regular screening and treatment of such beggars. Those positive should be actively treated and their close contacts frequently screened. This hidden reservoir should be completely eliminated.
authors.affiliation: Department of Community Health, Schieffelin Leprosy Research & Training Centre, Karigiri.
authors.forename: P S
authors.initials: PS
authors.lastname: Rao
authors.forename: N M
authors.initials: NM
authors.lastname: Mozhi
authors.forename: M V
authors.initials: MV
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006703:Ill-Housed Persons; D006801:Humans; D007194:India / Q000453:epidemiology; D007918:Leprosy / Q000453:epidemiology / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D011203:Poverty