SYSTEMATIC DOCUMENTATION-KEY TO IMPROVE CONTACT FOLLOW-UP: REVIEW OF PROGRAMME STRATEGY OF CHEMOPROPHYLAXIS FOR HOUSEHOLD CONTACTS OF LEPROSY PATIENTS, TIRUVALLUR DISTRICT, TAMIL NADU, INDIA, 2023

Abstract


INTRODUCTION : Analysis of five-year data of National Leprosy Eradication Programme in Tiruvallur district of Tamil Nadu revealed fluctuating annual new leprosy case detection, poor detection through contact tracing and no evaluation since implementation. In view of this, we evaluated the extent of implementation of the National Leprosy Eradication Programme (NLEP)’s strategy of chemoprophylaxis with single dose rifampicin to close contacts of leprosy during June to August, 2023. METHODS : Using log frame matrix, we framed input, process and output indicators and collected data through cross- sectional study across 45 health facilities. We interviewed 25 health staff implementing the programme, 57 index case- patients and their 147 household contacts. We extracted data from programme documents, reports and records generated by the district leprosy office. We obtained data on trained health care workers; availability of registers and rifampicin, information, education and communication (IEC) materials and allocated funds for drug procurement. RESULTS : Chemoprophylaxis with single dose rifampicin was 100 % accepted among household contacts. Majority of the programme staff received necessary training (78% of medical officers; 64% of other healthcare workers). They reported challenges such as the absence of contact registers and rifampicin stock at healthcare facilities. They enrolled 92% of index cases, screened all their household contacts to identify 91% of them eligible for prophylaxis. They provided rifampicin for 94% of them and none reported adverse events. IEC materials were displayed in 93% of the surveyed health facilities. In order to enhance the effectiveness of prophylaxis strategy, we recommend implementing systematic documentation by health staff for tracking contact follow-up and considering chemoprophylaxis to social and neighbourhood contacts. CONCLUSION: The chemoprophylaxis with single dose rifampicin to leprosy contacts was well accepted among leprosy affected persons and their household contacts after explaining the reduction of risk associated. The strategy of contact tracing followed by administration of single dose rifampicin is feasible and cost-effective.

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