ABSTRACT
The research investigated factors affecting migration, distant registration and their expected effects on leprosy service in Bangladesh. This qualitative study was conducted from April 2018 to September 2019. 130 leprosy-affected people (LAP) were selected for in-depth interview (IDI) and 23 professionals for Key informant's interview. A Semi-structured interview guide was used for data collection. Different factors were identified by key informants (KIs) and IDI participants (IDIPs) both for migration and for distant registration. Main factors for migration of LAP, mentioned by both groups, were fear of social exclusion. Lack of treatment facilities under the treatment category, job transfer under financial category and marriage under the personal category are the other main influencing factors for migration. Reasons for leprosy cases registering in distant places are similar to reasons for migration: lack of expert professionals under treatment category, relatives' influence under the personal category and job transfer under the financial category. It is concluded that migration and distant registration should be considered in studying the geographical distribution of leprosy. Interpretations proposed by key informants may not reflect the actual field situation. The opinions of those directly affected by leprosy should be sought and heeded in designing and evaluating leprosy programmes.
ABSTRACT
Migration has been a major influencing factor facilitating movement of disease between endemic and nonendemic areas. Both internal migration and global immigration contributes to spread to disease to nonendemic areas. This review discusses the findings of studies carried out all over the world regarding the role of migration in leprosy. It focuses on factors contributing to migration within the country, effect of migration on leprosy control programme, migration related factors adding to stigma and leading to administrative problems in leprosy control programmes. Migration of leprosy patients affects the opportunities to seek timely treatment at other places due lack of leprosy treatment facilities or awareness among the users. This review analyses the published studies available in PubMed and news articles related to migration in Leprosy. Out of total 2506 search results, only 18 were found to be relevant. In these studies migration has been identified as one of the important obstacles in achieving elimination of leprosy as the affected individuals may continue to spread the disease and themselves may suffer from disabilities with social consequences. The review also finds paucity of scientific studies carried out to study the role of migration in leprosy at present. There is clear need to focus on in depth studies on this aspect in the contemporary scenario for achieving the goal of world without leprosy.
ABSTRACT
Leprosy is still a relevant public health concern in Malaysia. Efforts made to eliminate leprosy gobeyond the elimination phase. Aspects that need to be taken into consideration include disabilityprevention, rehabilitation and ensuring maintenance of skills for diagnosing and treating the smallnumber of new cases that will continue to occur. This review article discussed about the experiencesof the past, achievement at present and the future challenges during the implementation of NationalLeprosy Control Program in Malaysia.
ABSTRACT
O presente estudo teve como objetivo avaliar o Programa de Controle da Hanseníase (PCH) no município de Governador Valadares e a descentralização das ações de controle para a atenção primária. Utilizou-se como referencial teórico-metodológico a Avaliação de Quarta Geração, segundo Guba e Lincoln (1989), de abordagem qualitativa. Participaram do estudo 30 sujeitos municipais, divididos em quatro grupos de interesse: gestores, profissionais do centro de referência (CR), profissionais da atenção básica (AB) e usuários dos serviços de saúde. Os dados foram coletados por meio de entrevistas individuais, utilizando-se a técnica do Círculo Hermenêutico-Dialético e, posteriormente, foram realizadas 3 Oficinas de Negociação com os atores municipais. Os resultados evidenciaram a permanência do modelo vertical de atenção à hanseníase no município, expresso pela concentração das ações de controle no CR e passividade da AB no desempenho das atividades do programa, demonstrando a insuficiência das estratégias de descentralização. Como determinantes que interferem no processo de descentralização no município, observou-se a influência de aspectos sócio-histórico-culturais como a imagem do CR no ideário social como local apropriado de atendimento à hanseníase, o estigma e a postura de distanciamento dos profissionais da AB, além da consolidação de práticas de saúde e gestão que reforçam a centralização do programa na atenção secundária. Além desses determinantes, observou-se, também, a influência de aspectos operacionais da rede municipal de saúde como problemas de acesso nas unidades básicas de saúde, instabilidade do quadro de recursos humanos, dificuldade de realizar a supervisão das equipes da AB e escassez de recursos financeiros do programa. Conclui-se que a problemática da descentralização em Governador Valadares envolve a tensão entre modelos de atenção distintos que coexistem no município, gerando disputas simbólicas no campo dos saberes e das práticas de saúde e de...
This present study aimed to evaluate the Leprosy Control Program (LCP) in Governador Valadares and the decentralization of control measures. This research used as theoretical and methodological reference the Fourth Generation Evaluation, Guba and Lincoln (1989), a qualitative approach. The study included 30 municipal subjects, divided into four interest groups: managers, professionals from the reference center (RC), primary care professionals (PC) and users of health services. Data were collected through individual interviews, using the technique of Hermeneutic-Dialectical Circle and later were performed 3 Trading Workshops, using group technique. The results showed the failure of decentralization strategies and maintenance of vertical LCP model in the city, characterized by passivity PC in leprosy control actions (LCA) and its concentration in municipal RC. Was observes a strong influence of socio-historical-cultural determinants in decentralization, as well as operational aspects of LCP and municipal health. Among the socio-historical and cultural aspects stood out: the historical reference of the secondary care service in the county, the distancing attitude of professionals PC, to the detriment of stigma and consolidating health and management practices that reinforce the centralization of LCP. Among the operational aspects, there were problems related to the access to the basic health units, frame instability of human resources, lack of resources for the program and difficulties in performing the supervision of teams of PC. We conclude that the issue of decentralization in Governador Valadares involves the tension between different models of care that exist in the city, generating symbolic disputes in the knowledge area besides health and management's practices. The sustainability of the decentralization process requires greater political involvement and institutional support, focusing on strengthening primary care, supervision of...
Subject(s)
Humans , Program Evaluation , Politics , Leprosy/prevention & control , Primary Health Care , BrazilABSTRACT
Though the early detection of leprosy is very important, it has been difficult to determine the M. leprae transmission in the community partly due to a lack of easy specific tools to measure it. A development of a seroepidemiological tool based on the phenolic glycolipid I(PGL-I), an M. leprae-specific antigen, made it possible to detect the M. leprae infection or exposure to the organism. In Korea, 11 studies, used it, were reported in the Korean Leprosy Bulletin. For the reduction of bias, we performed the integrated study of past 11 studies. In our study, we tried to find the useful values of the results of PGL-I Antibody IgM ELISA test for the control of leprosy and to know the further study for more valuable results.