INTERNATIONAL JOURNAL OF LEPROSY^ Volume 56, Number I

Printed in the U.S.A.

NEWS and NOTES

This department ,firrnishes ii?formation concerning institutions, organizations,and individuals engaged in work on leprosy and other mycobacterial diseases, andmakes note of scientific inectins,Ys and other matters of interest.

W. Felton Ross1987 Damien-Dutton Award Winner

On 6 November 1987, Howard E. Crouch,President of the Damien-Dutton Society forLeprosy Aid, Inc., presented the 1987 Da-mien-Dutton Award to W. Felton Ross,M.B.B.S., D.P.M.

This award is given once annually to anindividual or a group of individuals whohave made a significant contribution towardthe conquest of leprosy, either throughmedical care, scientific research, rehabili-tation, education, social welfare, or philan-thropy.

Dr. Ross is Medical Director of the Amer-ican Leprosy Missions, Treasurer of the In-ternational Leprosy Association, and Ex-ecutive Officer of the INTERNATIONALJOURNAL OF LEPROSY. He was born in Leo-

minster, England, and attended the LondonHospital Medical School. After internshipsand residencies in England, he was a le-prologist for the government of Nigeria for9 years, serving as Area Superintendent,Onitsha Province Leprosy Control Pro-gram. In 1960, on a WHO fellowship, Dr.Ross studied reconstructive surgery for 1year at the Schieffelin Leprosy Research andTraining Centre in Karigiri, South India. Hebecame Director of Training at the All-Af-rica Leprosy Rehabilitation and TrainingCenter (ALERT), Addis Ababa, Ethiopia,in 1966 and served in that capacity untilbecoming Medical Director of AmericanLeprosy Missions in 1976. He has servedas a short-term consultant to the WHO on

119

120^ International Journal of Leprosy^ 1988

numerous occasions, is a member of theILEP Medical Commission, and a memberof the ALERT Medical Advisory Group.

Dr. Ross maintains an incredible pace inhis work and travel. He has done, is doing,and undoubtedly will continue to do an

enormous amount of work for leprosy pa-tients and those who directly or indirectlylabor to improve their lot. Our best wishesto Dr. Ross on this well-deserved honor. —RCH

Previous Recipients of the Damien-Dutton Award

1953 Stanley Stein, U.S.A.^ 1970 Dr. Dharmendra, INDIA1954 Rev. Joseph Sweeney, KOREA

^1971 Dr. Chapman II. I3inford, U.S.A.

1955 Sister Marie Suzanne, FRANCE^

1972 Dr. Patricia Smith, VIETNAM1956 Perry Burgess, U.S.A.^ 1973 Dr. Jacinto Convit, VENEZUELA1957 John Farrow, U.S.A.^ 1974 Dr. José N. Rodriguez, PHILIPPINES1958 Sister !Mary Ross, U.S.A.^ 1975 Dr. Oliver Hasselblad, U.S.A.1959 Dr. II. Windsor Wade, PHILIPPINES

^1976 Dr. Yoshio Yoshie, JAPAN

1960 Mgr. Louis Joseph Nlendelis, U.S.A.^1977 Drs. Paul and Margaret Brand, U.S.A.1961 Dr. Kensuke Mitsuda, JAPAN

^1978 Dr. Fernando Latapi, MEXICO

1962 Rev. I'ierre de Orgeval, FRANCE^

1979 Dr. Stanley G. Browne, U.K.1963 Eunice Weaver, BRAZIL

^1980 Robert Watelet, ZAIRE

1964 Dr. Robert G. Cochrane, U.K.^1981 American Leprosy Missions, U.S.A.1965 John F. Kennedy, U.S.A. (Posthumous)

^1982 Dr. Ma Haide, PEOPLE'S REPUBLIC OF

1966 Peace Corps, U.S.A.^ CHINA1967 Dr. Howard A. Rusk, U.S.A.^ 1983 Murlidhar Devidas Amte (Baba Amte), INDIA1968 Dr. Franz Hemerijckx, BELGIUM

^1984 Mother Teresa, INDIA

1969 Dr. Victor George Heiser, U.S.A.^1985 Dr. John H. Hanks, U.S.A.1986 Samuel J. Butcher, U.S.A.

France. 411i International Colloquiumon the Mycobacteria. September 19-21,1988. 4th International Colloquium on theMycobacteria: Structure and Function inMycobacterhon leprae and other Difficult-to-Grow Mycobacteria (Institute Pasteur-Paris). Contact: H. L. David, M.D. Ph.D.,Unite de la Tuberculose et des Mycobac-tCries, Institut Pasteur, 25 rue du Dr. Roux,75724 Paris Cedex 15, France.

India. Multidrug therapy. It was felt thatin multidrug therapy (MDT) there weresome problems which needed to be re-solved. With this in view, an informal get-together of leprologists involved in MDTwas organized under the Chairmanship ofDr. D. D. Palande and held at the SacredHeart Leprosy Centre (SHLC), Kumbako-nam, India, 18-19 July 1987. The partici-pants included: Dr. K. V. Desikan (Seva-gram); Dr. C. J. G. Chacko, Dr. Arunthathi(SLRI-Karigiri); Dr. C. Vellut, Dr. C. Push-padas (Polambakkam); Dr. Pushpa Eapen(Hubli); Dr. R. Ganapati (Bombay); Dr. V.Ekambaram (Madras); Dr. D. Lobo, Dr.

Mathew (Madras); Dr. Jayakumar, Mr. Iru-dayaraj (Chetpat); Dr. P. Soundararajan(Tanjore); Dr. Ashok Mukerjee (Delhi); Dr.Dhilip Jogaikar (Pune); and staff membersof SHLC.

Short working papers or introductions ofproblems encountered were presented byparticipants. The consensus conclusions ar-rived at are as follows:

1. It was agreed that cases with less thanthree lesions including skin and nerve whichwere bacteriologically negative would betaken under the group of paucibacillary lep-rosy. The duration of treatment for this typewas taken as a minimum period of6 months;if there is no response in 6 months, it willbe extended to a maximum period of 12months. The treatment will consist of twodrugs, rifampin and dapsone. If signs of ac-tivity persist after 12 months, the patientwould be considered as belonging to themultibacillary group and given three drugs,namely, dapsone, rifampin and clofazi-mine, for a further 24 months.

2. All bacteriologically positive caseswould be considered as multibacillary.

56, 1^

News and Notes^ 121

3. All bacteriologically negative caseswith more than 10 lesions including nervelesions would be considered as multibacil-lary. They would be treated with three drugs,rifampin, dapsone and clofazimine.

4. The duration of treatment for multi-bacillary cases will be for a minimum periodof 24 months or until the lesions are bac-teriologically negative and clinically inac-tive. The signs of inactivity are given later.

5. The group of cases where the numberof lesions is 4 to 9 including one nerve in-volvement would be considered as pauci-bacillary. The cases with 4 to 9 lesions in-cluding involvement of two or more nerveswould be considered as multibacillary.

6. All multibacillary cases who are onmaintenance dapsone monotherapy shouldbe given multidrug therapy (MDT) withthree drugs for a period of 24 months afterwhich the treatment should be stopped.

7. Paucibacillary cases who are active andare on sulfone monotherapy or who are in-active and are on sulfone monotherapy hav-ing not fulfilled the criteria for cure shouldbe given MDT as for paucibacillary leprosy.

8. Pure neuritic cases with two or morenerves involved should be considered asmultibacillary and treated as such.

9. Pure neuritic cases who have one nerveinvolvement are to be considered as pau-cibacillary and given appropriate MDT.

10. Reversal reactions appearing within6 months after termination of treatment fol-lowing inactivity should be treated with ste-roids. If they do not subside with steroidtreatment, a diagnosis of relapse will bemade and treatment re-introduced as formultibacillary leprosy. Reversal reactionsappearing after 6 months will be consideredas relapse and treated accordingly.

11. Iritis and scleritis and similarophthalmic complications of leprosy areconsidered as signs of activity of the diseaseirrespective of activity or otherwise of skinor nerve lesions.

12. Erythema nodosum leprosum (ENL)reaction is considered as a sign of activity.

13. In cases with complications like neu-ritis or reactions the treatment should becontinued with MDT just as in monother-apy.

14. Signs of inactivity of leprosy:A. Paucibacillary leprosy: Clinical

inactivity consists of the absence of:1) extension of lesions; 2) infiltration;3) erythema; 4) fresh skin lesions; 5)tenderness of nerves; 6) fresh nerveparalysis; and 7) extension of anes-thesia; shrivelling, nerve thickeningor old deformity do not signify activ-ity.B. Multibacillary leprosy: 1) absenceof clinical activity as above; 2) in BB,BL, and LL cases bacteriologicallyskin smears should be negative ontwo occasions at an interval of amonth; 3) absence of ENL reactionand absence of acute iritis, scleritisand ophthalmic complications.

These recommendations are to be re-viewed with acquisition of experience.

Conveners:^Dr. D. D. Palande, M.S.,Chief SurgeonDr. G. Ramu, M.D.,Senior Physician

National Seminar on Social Science Re-search on Leprosy. The Centre for SocialScience Research on Leprosy (CSSRL) or-ganized a two-day National Seminar on So-cial Science Research on Leprosy to preparea research agenda with an interaction of so-cial scientists, medical scientists, leprolo-gists, and leprosy programmers and inter-national agencies. The seminar was held atthe Gandhi Memorial Leprosy Foundation(GMLF) at Wardha on 25-26 July 1987,and was sponsored by the Ministry of Healthand Family Welfare Government of India.

Proceedings of the seminar will be pub-lished shortly. Those interested in having acopy of the proceedings, free of charge,should contact: Research Scientist, Centrefor Social Science Research on Leprosy,Gandhi Memorial Leprosy Foundation,Hindinagar, Wardha 442103, India. —S. P.Tare

New director of JALA1A. Upon the re-tirement of Dr. K. V. Desikan, Dr. Hari-haran Srinivasan was selected as Directorof the Central JALMA Institute for Leprosy,Taj Ganj, Agra, effective 1 July 1987.

New director of SLR&TC, Karigiri. Fol-lowing the retirement of Dr. Ernest P. Frit-

111^ International Journal of Leprosy^ 1988

schi, Director of the Schieffelin Leprosy Re-search & Training Centre, Karigiri (TamilNadu), Dr. Melville Christian, Deputy Di-rector and Head of the Branch of the Epi-demiology and Leprosy Control of the samecenter, took over as Director on 8 May 1987.

Korea. Leprosy in the Democratic. Peo-ple's Republic of Korea. On the occasion ofattending the 40th Session of the WHO Re-gional Committee for South-East Asia atPyong-Yang, Democratic People's Repub-lic of Korea, Dr. M. F. Lechat, President ofILA. had the opportunity to discuss withofficials the situation of leprosy in NorthKorea.

Leprosy is apparently a minor problem.A specialized hospital for leprosy was es-tablished in 1947. Case-finding was con-ducted mainly through contact examina-tions, four times a year for 10 years afterthe detection of the index case. Contactswere given chemoprophylaxis with dap-sone. Sulfone treatment has now been sup-plemented with rifampin.

The number of inmates in the hospitalapproximates at present 100, with both typesof the disease. No new patient has been de-tected in the last 7 years in 5 of the 11 prov-inces for which information has been ob-tained. There are strict rules for discharge:discharged patients cannot work as foodhandlers, employees in kindergarten orschool teachers. It is considered that trans-mission has been interrupted. Fear of lep-rosy remains very great in the population,hence the type of measure endorsed.— Prof.M. F. Lechat

Switzerland. Fortieth World Health As-sembly. On 15 May 1987, the following Res-olution of the World Health Assembly To-wards the Elimination of Leprosy waspassed: The Fortieth World Health Assem-bly, recalling resolution WHA32.39 andprevious resolutions of the Health Assem-bly and the Executive Board regarding lep-rosy; noting: a) the increasing commitmentof several Member States to eliminate lep-rosy as a public health problem in theircountries, as part of their goal of health forall by the year 2000; b) the significant pro-gress made in recent years in leprosy treat-

ment, including the use of new drugs in mul-tidrug therapy, which has made leprosytreatment far more effective; c) the verypromising research advances being madetoward the development of early diagnosis,immunology and vaccines, leading to effec-tive leprosy prevention programs; d) the in-creasing role being played by nongovern-mental organizations in leprosy control; 1.urges Member States with endemic leprosy:1) to allocate adequate priority to and re-sources for leprosy control within their pub-lic health services as part of primary healthcare; 2) to strengthen health educationthrough the media and community partic-ipation with a view to overcoming the stig-ma and phobias traditionally associated withthe disease in many societies, and to insti-tute adequate legal guarantees protecting therights of cured leprosy patients; 3) to pro-vide improved training in leprosy for healthworkers ofall categories, and especially thoseworking in the field of leprosy, to ensureearly case-finding, accurate diagnosis, andthe implementation of multidrug therapyprograms; 4) to institute active programs,including research, for the rehabilitation ofleprosy patients who have acquired dis-abilities and deformities; 5) to work out asystem of awards, prizes and rewards foroutstanding contributions to leprosy con-trol and research. 2. Requests the Director-General: 1) to continue the successful tech-nical and scientific guidance to MemberStates and to support their multidrug ther-apy programs for leprosy control; 2) to in-tensify the Organization's activities in lep-rosy control by additional mobilization andcoordination of scientific and material re-sources directed at implementing multidrugtherapy, rehabilitation and training; 3) tostrengthen support for the development ofmore effective tools against leprosy throughmultidisciplinary research in both the nat-ural and social sciences; 4) to intensify thesearch for improved drugs and vaccinesthrough the Special Programme for Re-search and Training in Tropical Diseases;5) to promote further the partnership ap-proach between nongovernmental organi-zations, Member States and WHO to achieveleprosy control and rehabilitation wherenecessary; 6) to keep the Executive Board

56,1^ News and Notes^ 123

and the Health Assembly informed of theprogress made. —From Dr. S. K. Noordeen

U.K. LEPRA Medical Advisory I3oar1 17(11'

chairman. Professor John Turk, M.D.,D.Sc., F.R.C.P., F.R.C.S., F.R.C.Path., hasbeen appointed Chairman of the MedicalAdvisory Board (MAB) of LEPRA, theBritish Leprosy Relief Association. He takesover from Dr. R. J. W. Rees who retiredfrom the post at the end of October. Pro-fessor Turk, who is Sir William Collins Pro-fessor of Human and Comparative Pathol-ogy at the Royal College of Surgeons andthe University of London, has been on theLEPRA MAB since its inception and Dep-uty Chairman for 3 years. From 1978—1979 he was a member of the Medical Re-search Council subcommittee on the FutureProspects of Leprosy Research, and has closeconnections with leprosy centers around theworld, especially in India. His departmenthas been a graduate research and trainingcenter for leprosy workers for the last 18years, ten of these under the aegis of LEP-RA. Particularly close tics are maintainedwith the All-India Institute of Medical Sci-ences, New Delhi, and the Central JALMALeprosy Research Institute, Agra.

Professor Turk was educated at MalvernCollege and Guys Hospital Medical Schooland following military service in Egypt andCyprus became, successively, lecturer inbacteriology at the London School of Hy-giene and Tropical Medicine, a member ofthe science staff at the National Institute forMedical Research, and a Reader in Im-munology at the University of London's In-stitute of Dermatology.

Well known for his contributions to theimmunological understanding of variousaspects of leprosy, Professor Turk has beena member of the WHO Expert AdvisoryPanel on Immunology. He is an HonoraryMember of the Dermatological Societies ofPoland, Belgium, Japan and Israel, and ofthe Peruvian Pathology Society and the Pe-ruvian Society for Immunology and Aller-gy. Since 1978 he has been Editor of Clinicaland Experimental 1111111unology. From1978-1979 he was President of the Sectionof Clinical Immunology and Allergy of theRoyal Society of Medicine and Honorary

Editor, Royal Society of Medicine 1979—1985. He is author or co-author of 365 sci-entific papers and his books include "De-layed Hypersensitivity" and "Immunologyin Clinical Medicine," which has beentranslated into various languages includingJapanese and Bulgarian.

Retiring Chairman of the LEPRA MAB,Dr. Dick Rees, joined LEPRA in 1962 as amember of its Medical Committee. He be-came Chairman a year later and held thesame position at the head of the MedicalAdvisory Board which replaced it in 1974.He has also been a member of the LEPRAExecutive Committee for the past 23 years.As such he played a vital part in LEPRA'sdecision to establish its ongoing LeprosyEvaluation Project and vaccine trial in Ma-lawi. Dr. Rees continues to control the pro-duction and distribution of leprosy vaccinefor the Malawi project from the NationalInstitute for Medical Research, Mill Hill.He also supervises the LEPRA Elective Stu-dent Programme which enables Britishmedical students to spend periods workingin overseas leprosy centers.— LEPRA pressrelease

U.S.A. International symposium an-nounced. The Hawaii Dermatology Societywill hold an international symposium onthe Hawaiian islands of Molokai and Oahuon 22-28 August 1988. Formal sessions willbe devoted to atopic dermatitis, skin cancer,the acquired immunodeficiency syndrome,leprosy, dermatopathology, and medical in-formatics. Participants are encouraged todeliver their own papers. These should be5-10 minutes in length in English. Deadlinefor abstracts was 15 February 1988.

A special lecture on the history of Mo-lokai's famed Kalaupapa leprosarium willbe given by Anwei Skinsnes Law, author ofA Land Set Apart: The History of Leprosyin Hawaii. Tours of the Kalaupapa settle-ment have been arranged. For details con-tact: David J. Elpern, M.D., 3420-B KuhioHwy., Lihue, Hawaii 96766, U.S.A.

Pathology seminar at Candle. In addi-tion to the other seminars to be held at Car-ville as noted in the September 1987 issueof the JOURNAL, there will be a seminar on

114^ International Journal of Leprosy^ 1988

Hansen's Disease for Pathologists on 1-2November 1988(3-4 October for 1989). Theseminar will present up to date, practicalinformation on the histopathology of Han-sen's disease and the role of the pathologistin the diagnosis and treatment of the dis-ease. For details, contact: Director of Edu-cation and Training, GWL Hansen's Dis-ease Center, Carville, Louisiana 70721,U.S.A.

Venezuela. Dr. Jacinto Convit honored.Dr. Jacinto Convit has been selected to re-ceive the Prince of Asturias Prize for Sci-ence and Technical Research for 1987, inrecognition of his leprosy vaccine studies.

The prize was presented in October in Spainby His Royal Highness Don Felipe de Bor-bon, Prince of Asturias, son of Their Majes-ties the King and Queen of Spain and heirto the throne. Since 1981, the Principalityof Asturias Foundation has awarded thePrince of Asturias Prizes in eight categoriesto reward the scientific, cultural, and socialwork of persons, teams or institutions whoseactivities constitute an example for man-kind. The selection of Dr. Convit as therecipient of this prize is a well-deservedhonor for him personally and is an impor-tant recognition of the significance of sci-entific progress in the field of leprosy.—Ger-ald P. Walsh, Ph.D.

13th InternationalLeprosy Congress '88

Scientific programIntroductionThe organization of this Congress differs insome respect from the previous Congresses.In the past, there has been some criticismon the large number of oral presentations,which left little time for discussion. Postersalso received inadequate attention. It is forthis reason we have developed a new sched-ule. An outline of the sessions is as follows:

Each Congress day will start with a plenarylecture presented by an invited speaker.These sessions are chosen to give an over-view of current practices in different aspectsof leprosy and are called State of the ArtLectures. They will be followed by simul-taneous sessions covering the 12 Congresstopics. Participants are invited to submitabstracts describing these 12 areas. The ac-cepted abstracts will be programmed intothe Congress time schedule, either as posterpresentations or as oral presentations. Thescientific committee will arrange effective

ways for discussion of the papers and pos-ters.

State of the Art Lectures:Monday, September 12P. E. M. FineImmunological Tools for Leprosy ControlThis presentation will review immunolog-ical tools for detecting Al. leprae infection,for identifying high-risk individuals and forpreventing or ameliorating the disease. Thepresentation will concentrate upon the sen-sitivity, specificity and practicability of thecurrently available skin tests and serologicalassays and upon the implications of theseparameters for the potential usefulness ofdifferent tests in leprosy research and con-trol. Recent work on the identification ofgroups at high risks of infection and/or dis-ease will be reviewed, with reference to bothimmunogenetic and immuno-epidemiolog-ical studies. Vaccines will be discussed withreference to the current use and impact of

56, 1^ News and Notes^ 125

BCG and to the trials of "second genera-tion" vaccines.

Tuesday, September 13B. BloomMolecular Biological Approaches to

LeprosyIn the past few years, the advances in mo-lecular biology, immunology and geneticengineering have made possible many newapproaches to the study of Al. leprae. Thegenes of Al. leprae have been grown in avicarious host, E. co/i. Using monoclonalantibodies specific for Al. !clime, six majorprotein antigens of Al. leprae that containantigenetic determinants that are unique toM. leprae have been identified. Using thoseantibodies it has been possible to obtain thegenes for all those proteins and begin tosequence the DNA encoding the major an-tigens. This recombinant DNA technologywill permit the production of enzymes ofM. leprae in such quantity that it may bepossible to design new drugs with bacteri-cidal activity against Al. leprae.

Many clones of human T cells from lep-romin positive individuals, each derivedfrom a single immune cell, have been grownin vitro. These T cells can identify the an-tigens involved in cell-mediated immunityand possible resistance. Conversely, it hasbeen possible to identify T cells in lepro-matous patients that may be involved insuppressing protective immune responses.Finally, molecular genetics and recombi-nant DNA technology have made it possibleto introduce foreign genes into BCG vac-cines, offering the possibility of a new mul-tivaccine vehicle to deliver multiple anti-gens required for protection against leprosyand many infectious diseases in a single livevaccine. And we are only at the thresholdof what modern science has to offer.

Wednesday, September 14M. Becx BleuminkOperational Aspects of Multidrug

ChemotherapyImplementation of MDT requires extensivereorganization and up-grading of many as-pects of the leprosy control services. Theneed for managerial skills at different levels

of the leprosy control infrastructure is moreand more recognized.

The lecture will review practical prob-lems associated with the implementation ofmultiple drug therapy (MDT), such as theneed for alternative drug regimens, the sit-uations in which supervised treatment can-not be secured and the management of pa-tients with confirmed drug resistance. Theduration of treatment of paucibacillary pa-tients is also a matter of increasing concern,due to the occurrence of reversal reactionsafter release from MDT. Duration of nec-essary surveillance after release from treat-ment will be discussed. Implementation ofMDT has brought about widespread opti-mism. The questions are whether the hopefor results will materialize operationally andwhat are the best ways to make MDT asuccess.

Thursday, September 15C. K. JobNerve Damage in LeprosyWhat makes leprosy a major health prob-lem are the deformities it produces. It isprimarily a disease of peripheral nerves.However, neuritis, the characteristic featureof all forms of leprosy, is not well defined.Mechanisms responsible for nerve damagein leprosy are poorly understood. This lec-ture will describe the pathology and patho-genesis in all three forms of the disease: lep-romatous, tuberculoid and borderline. Thedamage caused by (I) the uninhibited growthof M. leprae inside Schwann cells and per-ineural cells, (II) the hypersensitivity reac-tions to M. leprae and its products, (III) thebreak in the blood-nerve barrier, (IV) thetight nerve sheath causing ischemia and (V)the effect of trauma will be discussed withthe details of clinical and experimental find-ings. The importance of identifying silentand active neuritis will be emphasized. Themedical and surgical management of neu-ritis will also be outlined.

Friday, September 16L. B. ValenciaSocial Aspects of LeprosyWith the growing recognition of the criticalrole of social factors in successful disease

126^ International Journal (Y. Leprosy^ 1988

control, social scientists representing var-ious disciplines have begun to undertake re-search which aims to identify obstacles tothe control or leprosy. Social scientists andmedical practitioners have linked togetherto develop an interdisciplinary perspectiveon health in general and leprosy in partic-ular.

The lecture will review recent studies con-ducted to observe perceptions and attitudesof patients, the cultural stigma of leprosyand the coping strategies of those afflictedwith the illness. Di nrences among culturesin dealing with and in preventing leprosywill also be emphasized.

Poster and Oral PresentationsThe 12 Congress topics which will be cov-ered through oral or poster presentationsare:

1. Immunology 7. Nerve Damage2. Clinical Aspects 8. Surgery and Re-3. Experimental habilitation

Leprosy 9. Ophthalmology4. Microbiology 10. Social Aspects5. Epidemiology 11. Experimental

and Control Therapy6. Treatment 12. Pathology

Oral PresentationsFour oral presentations of 10 minutes eachwill be scheduled during each hour in threesimultaneous sessions. In addition, 5 min-utes of discussion will be scheduled fof eachpresentation. Approximately 300 oral pre-sentations can be accepted.

Poster PresentationsOnly 400 poster presentations can be ac-cepted. They will be selected and groupedin accordance with the 12 Congress topics.

Every oral presentation block on one ofthe Congress topics will be followed by theposter session of the same topic. During theposter sessions, the poster presenters will beavailable to discuss their posters.

The size of the posterboard is 1.20 x 1.20m. The poster should be ready in advance.However, students from art schools in TheNetherlands will be available in the Con-gress center on Sunday, 11 September, from09.00 hrs. to advise and assist poster pre-senters.

Teaching and Training SessionsA set of 13 audio/slide presentations on keytopics in leprosy patient care will be pre-sented in English, French and Spanish dur-ing the Congress. Copies of the slides, audiotapes and scripts in English will be on sale.These presentations will be of special inter-est to those engaged in teaching. As in 1984the presentations are being prepared by ex-perts in the various topics. Six of the topicsare completely new and have been preparedspecifically for the 1988 Congress.

The topics are: The role of the immunesystem in leprosy, Histopathology and clin-ical signs of early leprosy, Case taking, Ep-idemiology and leprosy control, Informa-tion systems, The eye in leprosy, Eye lesionsin leprosy, Early detection and manage-ment, Recognition and management of re-active phenomena, Pathophysiology ofnerve damage, The anesthetic hand—as-sessment and management, The anestheticfoot—assessment and management, Chem-otherapy, Health education and measuringthe effectiveness of health education.

Congress RegistrationRegistration forms are available from: 13thInternational Leprosy Congress '88, % QLTConvention Services, Keizersgracht 792,1017 EC Amsterdam, The Netherlands.

Hotel ReservationsHotel reservation forms are available from:13th International Leprosy Congress '88, %Convention Travel International, P.O. Box82170, 2508 ED The Hague, The Nether-lands.