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Feasibility of Integrating Leprosy Post-Exposure Prophylaxis with Single-Dose Rifampicin (LPEP) into Routine Leprosy Control Program in Bukedi and Teso Regions in Uganda

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Advances in Infectious Diseases 2024年第3期14卷 563-580页

作者： Rose Kengonzi Turyahabwe Stavia Lisa Gerwing-Adima nyote ronald Kamara Vincent Consolata Mbambara Yusuf Wanyama Buyinza Godfrey Tinyo Daniel Mulwani Elisa Namuyode Damali Aloket Francis Ministry of Health National Tuberculosis and Leprosy Program Kampala Uganda German Tuberculosis and Leprosy Relief Association Kampala Uganda Kibuku District Local Government Kibuku Uganda Budaka District Local Government Budaka Uganda Department of Internal Medicine Mbale Regional Referral Hospital Mbale Uganda Department of Internal Medicine Soroti Regional Referral Hospital Soroti Uganda

Background: World Health Organization recommends the implementation of contact tracing and Leprosy Post Exposure prophylaxis (LPEP) to interrupt the chain of transmission. To accelerate the uptake of this recommendation, a cross-sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating leprosy systematic contact tracing and post-exposure prophylaxis (PEP) into the routine leprosy control program. Methods: This was a mixed methods cross-sectional study. The study was implemented in Kumi, Ngora, Serere, Soroti, Budaka and Kibuku Districts. Results: The 45 enrolled index patients (97.8% of the registered) identified a total of 135 contacts, of which 134 (99·2%) consented and were screened. Among them, one new leprosy patient was identified and started on treatment with multidrug therapy (MDT). All the eligible contacts, received the prophylactic treatment with Single Dose Rifampicin (SDR). Overall, SDR was administered to 133(98.5% of the listed contacts) with no adverse event reported. Factors associated with successful contact investigation and management included: Involvement of index patients, health care workers during the contact screening and SDR A administration, counselling of the index patients and contacts by the health care works, LPEP being administered as Directly observed Therapy (DOT) among others. Results Interpretation: The integration of leprosy post-exposure prophylaxis with administration of SDR and contact tracing is feasible, generally accepted by the patient, their contacts and health workers and can be integrated into the National Leprosy control programmes with minimal additional efforts once contact tracing has been established. Therefore, we recommend integration of administration of SDR in to the routine leprosy control program.

关键词： Leprosy Post Exposure Prophylaxis Single Dose Rifampicin

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Exploring the Pathways of Leprosy Patients from Their Communities to a Diagnosis in the Districts of Mayuge, Yumbe and Kasese-Uganda

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Advances in Infectious Diseases 2024年第2期14卷 346-373页

作者： Rose Kengonzi Stavia Turyahabwe Samuel Orach Lisa Gerwing-Adima ronald W. nyote Vincent Kamara Kabugho Faith Consolata Mpambara National Tuberculosis and Leprosy Program Ministry of Health Uganda Kampala Uganda Health Department Uganda Catholic Medical Bureau Kampala Uganda German Leprosy and Tuberculosis Relief Association Kampala Uganda National Tuberculosis and Leprosy Program Kampala Uganda

Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity buildi

关键词： Leprosy Patient Pathway Skin Lesions Disability Discrimination Delayed Diagnosis

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Exploring the Pathways of Leprosy Patients from Their Communities to a Diagnosis in the Districts of Mayuge, Yumbe and Kasese-Uganda

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Advances in Infectious Diseases（传染病进展） 2024年第2期 346页

作者： Rose Kengonzi Stavia Turyahabwe Samuel Orach Lisa Gerwing-Adima ronald W.nyote Vincent Kamara Kabugho Faith Consolata Mpambara

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