Comment: implementing multidrug therapy in areas not covered by the health services--some experiences from Chad.

Sir, After reading the article by Ahmed & EI Tahir2 in Leprosy Review we would like to share our experiences in Chad. The Guera Prefecture, located in central Chad, covers a population of 300,000 scattered over an area of 60,000 km2 . Health services are poor, only 1 2 out of 32 designated health zones are covered by the health services. Even where health facilities exist, the quality of health care is often poor due to the lack of qualified staff. In addition to poor health service coverage, communications constitute a major problem. Large parts of the Prefecture are inaccessible during the rainy season. The Guera Leprosy and Disability Control Project (funded by The Leprosy Mission) has taken an active role in implementing multidrug therapy (MDT) within the framework of the National Leprosy Control Programme of Chad. l MDT was introduced in the Guera in 1 992. From 1 992 to 1 996, 545 patients (233 MB, 3 1 2 PB) have been put on MDT.