Model development of referral system for leprosy patients and enhancement of quality of leprosy control under low endemic condition, Surin Province

Abstract

This study was conducted as the operational research. The study aimed at development of model of referral systems for leprosy patients and increase the quality of leprosy control under the low endemic conditions of Surin Province. We gathered information for the study through situation analysis, observation, academic documents, and leprosy experts' recommendation. The data from the observation and relating conferences provided the design of development pattern. The study was divided into 4 stages; (1) Studying and assessing operational situation of leprosy prevention and control. (2) Formulating a new model of referring system. (3) Following, and monitoring the operation according to the predetermined model. (4) Evaluating the results was. In 2014, we assessed of the operational results of leprosy control after developing the new referring system in Surin Province. We found that the competency and quality of leprosy control at Surin Province was changed more effectively, such as the formation of having the visit teams from several hospitals in Surin Province to visit the leprosy patient at home and perform contact examination. In addition, they also provided on the spot training to the village health volunteers about how to screen people with chronic skin diseases in order to find new leprosy patients. The finding number of new cases of leprosy patients in 2011-2014 had increased to 10, 21, 8, and 16 cases respectively. The number of new leprosy cases with disability grade 2 had decreased from 7 cases to 4 cases. The completion rate of treatment are likely to rise. They are more able to diagnose the new cases from household contact tracing. Thus, we recommend the other provinces to apply this referral system model by better utilization of regional hospital as hospitals at lower levels can help supporting contact tracing and screening of suspicious cases and sent to the regional hospital. Apart from that, they also recommended that survey for the leprosy patients' satisfaction toward the service of leprosy clinic should be conducted in order to evaluate the quality and effectiveness of the new referral system model. These will further enhance the quality and standard of the referral system of leprosy control under low endemic condition.