The quality of the search for new cases of leprosy, treatment follow-up and finding household contacts of new leprosy patients in 9th health region during 2010-2019

Abstract

Background: Leprosy remains a regional problem in Thailand. In 2019, the prevalence and detection rate of new cases in 9th health region was higher than that of the country. The objectives of this study were to determine the quality of finding new leprosy cases, quality of treatment of new leprosy cases and quality of household contact tracing of new leprosy cases in 9th health region, 2010 to 2019, to provide policy recommendations to achieve the goal of eliminating leprosy in a sustainable way.
Methods: A quantitative and retrospective descriptive study was conducted. Data were collected from documents and reports from the leprosy database (UCHA) in 9th health region, 2010 to 2019. The quality assessment was based on guideline of the Department of Disease Control, Ministry of Public Health.
Results: There are 481 new cases of leprosy, separated into males 58%, and females 42%. Sixty-six cases had level-2 disabilities. There are 70% multibacillary leprosy, and 30% paucibacillary leprosy. The proportion of new multibacillary leprosy tends to increase while the proportion of new leprosy children aged 0-14 years tends to decrease. The proportion of cases with awareness self-reporting was good, 87%, while 3% referred, and 10% contacts. The quality of accelerating the search for new leprosy patients revealed using the proportion of new patients with a level-2 disability which was 14%. When looking at the trend, patients with level-2 disabilities were found consistently every year. Consistently with the proportions of new leprosy patients who receive treatment within 12 months of onset of leprosy, most of them did not pass the criteria. The quality of treatment of new leprosy patients assessed by the MDT completion rates for multibacillary leprosy and paucibacillary leprosy, were mostly passed the criteria. For the quality of finding and examining new contacts of leprosy patients, we found that the rates of household contact examination did not pass the criteria.
Discussion and Conclusion: Leprosy elimination operations of the 9th health region in 2010-2019 were in relatively good conditions in all activities. However, the activity of finding new cases of leprosy each year lacks consistency, causing the number of new cases of leprosy patients fluctuated and the number of new leprosy cases with level-2 disabilities was higher than the country criteria. For the quality of treatment of new leprosy patients, we found that the completion rate mostly passed the criteria. However, the quality of case finding and examining contacts of leprosy patients urgently improved. Therefore, those in charge of leprosy control and prevention program should be urgently aware of the problems and find solutions to improve the leprosy elimination operations in all activities in order to achieve the goals in the 2020-2027 strategic plan.