Leprosy Case Finding Model by Household Contact Survey in Low Prevalence Area; Nadun District, Mahasarakham Province

Abstract

This action research aimed; 1) To study problems of new case findings in leprosy patients' household contacts. 2) To develop working processes and evaluate results of the processes, according to the plan of new case findings in leprosy patients' household contacts to develop a model of the leprosy case finding in low prevalence area under PDCA (Plan-Do-Check-Act) process. The quantitative and qualitative study was conducted at Nadun District, Mahasarakham Province, using two researched tools. The first tool was a questionnaire, in which the samples were 20 health personals who responsible for the leprosy program in the district and subdistrict levels. The second tool was the focus group discussion. The discussion in groups was performed, including district hospital nurses and technical officers from health-promoting hospitals were 10 health personals. The results revealed that leprosy new case finding policy was not the key performance indicator in the service plan since there was no activity and monitoring. Moreover, the health care system lacked screening and data referral systems, health care personal lacked knowledge, and local residences lacked health care perception. There were five planning projects to solve the problems, which consisted of 1) potential improvement for health care personnel in the leprosy control program. 2) Active case finding in risk groups. 3) Leprosy knowledge training for community leaders and volunteers. 4) Strengthening potentials in health care personnel about leprosy health care planning and referral system. 5) Risk communication for public awareness to prevent and control the disease.

          The results had shown that 1) Screening in suspected cases should be initiated. 2) Data management of community contacts should be developed. 3) Effectiveness of the referral system should be enhanced, leading to collaboration between each local health care system and a settlement of policy advocacy. Furthermore, the local government organization could become aware of the leprosy situation and its effects in the area so that allocating health funding to support leprosy case finding models in low prevalence areas would be initiated.