Résumé
The leprosy elimination at national level was achieved in India in December 2005, however, Chhattisgarh is the only State yet to achieve same at State level and reported highest ANCDR/100000 population, i.e., 29.7 as on 31st March 2020. The efforts of the National Leprosy Eradication Programme (NLEP) are admirable wherein several initiatives introduced in phased manner since 2015, but there is need to understand the local scenario for effective control of this chronic disease in Chhattisgarh. This study conducted to identify various socio- demographic, behavioural, environmental factors associated with leprosy occurrence in high endemic district named Raipur. A community-based case control study design was adopted with inclusion criteria for cases as diagnosed, confirmed, and classified leprosy patients as per the WHO recommendation and NLEP Guidelines and controls as matched with cases' sex, age, (excluding the family members) and inhabiting same local area. Total 448 cases and 439 controls were interviewed from the district, after stratification of blocks based on G2D percentage among new cases detected & distribution of the sample (meant to be drawn from district) in proportion to the new cases reported by each stratum during year 2019. Data regarding socio-demographic profile, personal practices, disease profile & case history was collected through 2 different predesigned schedules. Descriptive, stratified analysis was performed along with chi square test score calculation for each variable. Further, bivariate & multinomial logistic regression was done to calculate adjusted odds ratio (for religion, age, caste, gender, education, occupation, residential area, family income) as measure of association. Low education level, absence of windows and safe water supply in household, use of same towel by multiple family members and history of contact with leprosy patients in family/ friends were found to be significantly associated with leprosy occurrence. The interventions targeted against these factors, i.e., emancipation of education level, IEC for hygiene, ventilation etc. may help in curbing the leprosy transmission in this high endemic district and other districts facing the same menace.
Résumé
Background: Leprosy has been known to the Indians since the Vedic period. Leprosy is synonymous with social stigma due to reasons like mystery around its transmission, lack of knowledge on available treatment, deformities and religious views. Prejudice and lack of knowledge about leprosy exist even among medical practitioners and healthcare professionals around the world. Considering above mentioned facts, this study was conducted to study knowledge and attitude of medical students and interns towards leprosy. Methods: A cross-sectional study was conducted at IGGMC, Nagpur, among Third MBBS part one of 7th semester medical students who were exam going for community medicine and interns of IGGMC between October 2018 to January 2019. Questionnaire comprised of 27 knowledge-based and 22 attitude–oriented questions. In all total 210 subjects, 99 Interns and 111 students were enrolled for the study. Results: Mean age of interns was 23.52±0.66 years and that of students was 21.45±0.85 years. There was no significant difference in knowledge regarding cause and modes of transmission and clinical features of leprosy between interns and student however interns were having significant higher knowledge regarding diagnosis, treatment, prevention of deformity limitation and precaution to be taken against leprosy. Only 13(6.19%) participants were having knowledge regarding targets of NLEP that was to be achieved by year 2017. Though both interns and students both showed good attitude towards leprosy but only 34 interns and 31 students had ever rendered service or donated money for cause of leprosy. Conclusions: Knowledge regarding national program is limited in both groups, curriculum should be strengthen pertaining to National program.
Résumé
The Elimination of Leprosy at National level was achieved in the month of December, 2005, by India. Afterward it was observed that trend of two important indicators of NLEP i.e. Annual New Case Detection Rate (ANCDR) and Prevalence Rate (PR) are almost static since 2005–2006, whereas the percentage of Grade II disability (G2D) amongst new cases detected showed a rising trend, which indicated delayed detection of cases and quantum of cases lying undetected/ hidden in the community. Hence, in order to address the issues being faced by programme an innovative approach for hidden case detection i.e., Leprosy Case Detection Campaign (LCDC) was introduced by Central Leprosy Division (CLD), Directorate General of Health Services (Dte.GHS), Ministry of Health & Family Welfare (MoHFW), Govt of India. This novel concept is first of its kind in the world as it has various unique features i.e., institutional framework at various administrative levels for planning, implementation and concurrent review of LCDC, formulation and training of search teams, Micro plan preparation, IEC activities, supervision and monitoring by identified supervisors and report submission. The activity was piloted in the limited areas of 50 districts of 7 states during March-April 2016 and in September, 2016 it was expanded to 163 districts of 20 States/ UTs to cover around 360 million population. During 2017, it was implemented in 255 districts of 23 States/ UTs to cover population of around 390 million. These efforts have yielded the desired result which is evident from the fact that approximately 67000 new leprosy cases were detected during the LCDCs in these 2 years (2016-17 & 2017-18) and number of G2D cases per million population also declined by more than 25%, from 4.48 cases per million in 2014-15 to 3.34 cases per million in 2017-18. In addition to the above, the benefits achieved through LCDCs are generation of large number of trained manpower who can suspect, identify leprosy cases and can carry out focussed IEC regarding leprosy.
Résumé
Background: Leprosy has been a literal scourge through the history of humanity and to eradicate the disease from high endemic countries need leprosy services to be sustained and they remain of good quality. Objective: The present study aimed for getting a reasonable impression of the client’s views on a range of quality aspects of leprosy services rendered by district leprosy control unit under national leprosy eradication programme(NLEP). Methodology: Cross- sectional study was conducted in Satara district of western Maharashtra, India among registered leprosy patients under district leprosy control unit during April -July2008. A sample of 25 % of registered leprosy cases were selected by random sampling method from primary health centers and urban leprosy control units to assess the patient’s satisfaction under the functioning of NLEP. After verbal consent, participants were interviewed at home site using pre-tested structured proforma include socio -demographic and patient satisfaction variables. Data collected was compiled and analyzed by using statistical software. Results: Patient’s overall level of satisfaction was very good i.e. 88.89% with max, 46.03% cases were from age group 35 to 52 years. Max, 47.61% cases were illiterate with high case detection rate, 52.38% was seen males. The proportion of multi-bacillary (MB) and pauci-bacillary (PB) cases was 65.07 % & 34.92 % respectively. Most of the patients were satisfied with anti-leprosy drugs, health education and no physical deformity due to disease underline. 98.41 % patients were satisfied about follow- up and motivation services. Satisfaction about diagnosis of disease by doctors and starting of treatment was 96.82 % and 95.23 % respectively, however satisfaction with rehabilitative services was 14.28%. Significant statistical association was existed between age of leprosy affected cases and their level of satisfaction under NLEP services (?2=15.92,p <0.05*). Conclusion: Elimination of leprosy and very good patient satisfaction towards leprosy services in Satara district indicates successfulness of NLEP.