Keywords

colony community Coping Disability Discrimination entitlements Geographical distribution Intervention Leprosy leprosy Multibacillary Participation Scale Paucibacillary Person affected by leprosy research priorities Resilience Social participation Spatial-temporal analysis states Stigma

Volume - 90, Issue - 1

editorial
Pages 1 - 2
Original Papers
Pages 3 - 30
  • Reviewing Research Priorities of the Leprosy Research Initiative (LRI): a stakeholder’s consultation

    • Zahra Khazai
    • Wim Van Brakel
    • Dirk Essink
    • Tom Gillis
    • Christa Kasang
    • Pim Kuipers
    • Paul Saunderson
    • David Scollard
    • Nienke Veldhuijzen
    Volume 90, Issue 1

    | Published on March 2019

    Introduction:

    Leprosy is a neglected tropical disease and although a cure is available, each year over 200,000 persons are newly diagnosed with leprosy and many more suffer from long-term complications, such as disabilities. The Leprosy Research Initiative (LRI) provides competitive research funding for research projects related to one of five research priorities. Five years after its launch in 2013 and with new developments in the field, the LRI consulted a wide range of stakeholders to evaluate its research priorities and to contribute to a wider research agenda.

    Material & Methods:

    A mixed methods approach was used in which qualitative methods (enquiry panel, focus group discussions (FGD) and key informant interviews) were followed by quantitative methods (e-survey and Delphi process). The Delphi process was the final phase of the study with the aim to reach consensus on the priority ranking of the research topics.

    Results:

    In total, 124 people contributed to the study. Stakeholders consulted included leprosy-affected persons, researchers, health professionals and policy makers. 50% of the participants came from Africa, Asia or Latin America (endemic areas). In total, 84 research topics were identified. The Delphi process resulted in three top five lists of research topics in the categories Zero Transmission, Zero Disability and Zero Discrimination.

    Discussion:

    In conclusion, 15 research priorities categorised in Zero transmission, Zero disabilities and Zero discrimination were prioritised in this study. A research priority new to LRI was research into the mental health of persons affected by leprosy. These findings are not only relevant for the LRI – but may also contribute to research agenda setting by others, most notably the Global Partnership for Zero Leprosy.

Original Papers
Pages 31 - 45
  • Acceptability of contact screening and single dose rifampicin as chemoprophylaxis for leprosy in Dadra and Nagar Haveli, India

    • Hermant Apte
    • Meena Chitale
    • Shweta Das
    • Pratap R. Manglani
    • Liesbeth F. Mieras
    Volume 90, Issue 1

    | Published on March 2019

    Background:

    Single-dose rifampicin as post-exposure prophylaxis (SDR-PEP) for leprosy given to contacts of leprosy patients was proven to reduce their risk by 57%.1 The Leprosy Post-Exposure Prophylaxis (LPEP) program evaluates the feasibility of integrating SDR-PEP distribution into leprosy control programmes in eight leprosy endemic countries, among which India is one. Acceptability by the main stakeholders is an important component of feasibility and essential for sustainability and scale-up of health interventions. This study looked at the acceptability of the introduction of SDR-PEP in the LPEP project area in India.

    Study design:

    The acceptability of the implementation of the LPEP project was assessed in the Union Territory of Dadra and Nagar Haveli (DNH) in India. This was done through a qualitative cross-sectional study using semi-structured interviews and focus group discussions with the main stakeholders of the intervention. A quantitative component of the study was the compliance rate of index patients and their contacts in accepting contact screening and SDR-PEP administration.

    Results:

    The intervention was generally regarded as beneficial. Participants understood that SDR-PEP prevents the development of leprosy. Disclosure of the leprosy status of patients was needed to approach their close contacts. This was not a barrier for the administration of SDR-PEP. The trust in the health services, health staff and the gender sensitive approach contributed importantly to the high level of acceptability. The compliance rate was 99.0% among leprosy patients and 98.6% among contacts.

    Conclusion:

    Contact screening and SDR-PEP distribution in DNH, India, has been very well accepted by the main stakeholders: index patients, contacts, health workers and supervisors.

Original Papers
Pages 46 - 56
  • Spatial-temporal dynamics of leprosy in Wuhan, China, 1950–2017

    • Liang Chen
    • Jian Chen
    • Man-Qing Liu
    • Xia Gao
    • Jun Gao
    • Quan Hu
    Volume 90, Issue 1

    | Published on March 2019

    Aim:

    In the past 60 years, the number of registered leprosy patients has decreased significantly in Wuhan, China. However, the process behind this remains unknown. Thus, the aim of this study is to analyse the spatial-temporal dynamics of leprosy in Wuhan from 1950 to 2017.

    Methods:

    The data of leprosy patients from 1950 to 2017 in Wuhan city was downloaded from Leprosy Management Information System (LEPMIS) in China. By using Arcgis (Version 9.3) and Satscan (version 9.4), we analysed the spatialtemporal dynamics of leprosy, including multibacillary and paucibacillary types.

    Results:

    3655 leprosy patients including 1201 with multibacillary leprosy (32.9%) and 2454 with paucibacillary leprosy (67.1%) were enrolled in this study, which showed a significant decrease from 1950 to 2017, and marked transformation of the majority type of leprosy from multibacillary to paucibacillary (p < 0.0001) in Wuhan city. The spatial-temporal analysis of leprosy patients indicated that the distribution changed gradually from clusters in the urban areas to scattered cases in the suburban areas. There has been no cluster of leprosy patients since 2000 in Wuhan.

    Conclusions:

    The results of this study suggest great changes within Wuhan, implying that within the low endemic areas of leprosy in China, the focus should be on strengthening systems for monitoring early symptoms.

Original Papers
Pages 57 - 67
Click to load more