The leprosy registry’s significance

The leprosy registry became a valuable tool for the health authorities in the practical work of preventing the spread of the disease. Since the district medical officers sent in forms at least once a year, the public health issue could be continuously monitored. It enabled the progression and regression of the disease to be tracked in different geographical areas, and different measures to be planned, implemented and assessed. The overview also provided a basis for monitoring and potentially implementing direct interventions for different individuals, such as the hospitalisation of the most severely ill, who were considered most infectious, as it was not possible to institutionalise everyone.

In the latter half of the 19th century, opinion remained divided about what caused leprosy, and there was consequently disagreement about the best way to combat the disease. However, the leprosy registry strengthened the argument that the disease was infectious and that isolation was the most effective measure to prevent its spread. In 1888, medical officer Hansen concluded that, according to statistical data, the measures implemented to prevent the spread of the disease had been successful, i.e. registering those with leprosy, building institutions and isolating the most infectious.

The ability to evaluate the health authorities’ measures by using such a system attracted international attention. The significance of the leprosy registry in combating the disease was clearly expressed at the end of the first International Leprosy Conference in Berlin in 1897. At the conference, the following resolution was adopted: ‘the system of obligatory notification and of observation and isolation, as carried out in Norway, is recommended to all nations with local self-government and a sufficient number of physicians.’

The leprosy registry represented a medical innovation, and the experience gained naturally had an impact on the development of disease registration in Norway. In 1900, tuberculosis registration was introduced, albeit on a smaller scale than the leprosy registry, and for a long time, it only included local registrations. The tradition of patient registries, which started with leprosy and continued with tuberculosis, was then extended to include the registration of non-infectious diseases as well.

Map of the distribution of leprosy in Norway 1856 and 1890. Photo: Bergen City Museum.
The leprosy registry provided for the first time reliable data about the prevalence of leprosy in Norway Data from the registry showed a dramatic decrease in the number of leprosy cases over the course of just a few decades, and it was concluded that isolation was the most effective measure to limit the spread of the disease.
From the ‘General Report’ from the ‘Tables of People Diagnosed with Leprosy in Norway’ in 1875 in which Hansen, during his first year as ‘Chief Medical Officer for Leprosy’, argues that the figures from the leprosy registry indicate that the disease must be infectious. The publication always contained a report from the chief medical officer, but from 1875, the year that Hansen was appointed, it also contained more concrete descriptions of the disease’s spread. During the 36 years that Hansen served as chief medical officer, the reports became more numerous and detailed, showing not only the number of cases in different districts and the ages and sexes of those affected, but ever more detailed statistics about the form of disease, life expectancy and the cause of death.
Statistics Norway,

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