Development of new leprosy case finding models for leprosy close contacts in Lower South of Thailand

Abstract

This action research (AR) aimed to develop new leprosy detecting model and describe its outputs among 10 index cases, who are newly diagnosed leprosy patients in Lower South Thailand between July and September 2017. The AR was divided into three parts: (1) preparation, (2) operation, and (3) evaluation. Quantitative data were collected using questionnaire and data recording form and were described using descriptive statistics. Qualitative data were gathered by field participatory and small-group reflection techniques and were analyzed using content analysis, constructivism and triangulation. We developed and implemented four models: (I) home visit, (II) Raj Pracha Samasai campaign and close contact tracing, (III) rapid village survey and close contact tracing, and (IV) integration to other health activities and close contact tracing. The results showed that 506 leprosy close contacts were identified and 179 of them (35.4%) were willing to participate in leprosy case finding processes. The case finding systems captured 3 leprosy patients, all patients were identified based-on model-II, and 5 primary cases of leprosy were revealed. Total case finding resulting from the models I to IV was 34.5%, 43.2%, 43.4%, and 14.3%, respectively. The reflection method showed that a development of new leprosy case finding system must be consistent with (1) un-arrested zone circumstance, (2) socio-cultural and indigenous believing platform, (3) stakeholders’ willingness to be involved, (4) model deploying’s time and traditional way of life, (5) knowledge and skills of health care providers and stakeholders, (6) prevalence of leprosy, and (7) leprosy and close-contact database. The development of leprosy case finding focusing on specific close contacts (Model II) provided the highest output. It also received high acceptance, co-operation from all stakeholders and had capacity to detect new leprosy cases.