text only Assessment of Disability due to Leprosy using the WHO Disability Grades Accurate assessment of disability due to leprosy using the WHO Disability Grading is important. It is used to monitor diagnosis (it indicates whether diagnosis is early or late) and it is used as an indicator of the effectiveness of treatment (the progress of patients during MDT is monitored using the WHO disability grading). The WHO disability grade is a simple method to assess impairments in the Hands, Eyes and Feet of patients taking MDT. It is described in the Operational Guidelines for the Enhanced Global Strategy (2011-2015) - see page 22 - 25. The overall WHO Disability Grade (the WHO maximum Disability Grade) should be recorded for each patient, but it is also recommended that a patient’s progress through treatment should be assessed using the EHF score. The EHF score is when the grading for both eyes, both hands and both feet are added together. It is important that the WHO Disability Grades are accurate and reliable. There is wide variation in the disability grading between and within countries. This may be due to real differences or due to differences in the way the Grading is implemented. We would like to check to see if disability assessments are conducted and recorded in the same way everywhere. To help assess this situation, we would like as many people as possible to complete the following 20 questions (your answers will be completely anonymous). We will circulate the answers on the LML Leprosy Work Q1 How long have you worked in the leprosy field?   Less 1 year   1-5 years   More than 5 years Q2 Have you received any training in leprosy?   Yes   No   Q3 Did the training include assessing disability?   Yes   No   Not Applicable Recording of Disability Assessment Q4 Does your patient record card include Disability Grade?   Yes   No   Not Applicable Q5 Does your patient record card include disability grades for both eyes, both hands and both feet?   Yes   No   Not Applicable Q6 Does your record card include the EHF score?   Yes   No   Not Applicable Q7 Is disability assessed at each clinic visit?   Yes   No   Not Applicable Q8 Is disability grade at MDT completion recorded?   Yes   No   Not Applicable Disability Assessment What is the maximum disability grade for a patient with ... Q9 with only loss of sensation and a planter ulcer on one foot?   0   1   2 Q10 with only loss of sensation on both hands?   0   1   2 Q11 with only loss of sensation on skin patches on his body?   0   1   2 Q12 with only skins nodules on his body and face?   0   1   2 Q13 with only cracks in his feet?   0   1   2 Q14 with only wounds on his left foot from a road accident?   0   1   2 Q15 with only loss of eyebrows and thickened earlobes?   0   1   2 Q16 with scars of healed ulcers and loss of sensation on both feet?   0   1   2 Q17 with muscle weakness in his hands but no clawing?   0   1   2 Q18 with an eye cataract?   0   1   2 Q19 with severe visual impairment in one eye (< 6/60 VA)?   0   1   2 Q20 what is the EHF score for a patient with loss of sensation in both hands and both feet, one plantar ulcer and lagophthalmos in one eye?   0   2   4   6   8   10   12 1   3   5   7   9   11

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