A comparative study of intervention methods (full, partial and non-integration) on late case detection and treatment irregularity in Yangon, Myanmar.

The high percentage (20%) of new cases with grade 2 disabilities, and a low treatment regularity of 47% indicated problems in case detection and case holding in Urban Yangon. The fact that Urban Health Centers (UHCs) were not involved in leprosy control programme might have had an adverse influence. To compare the effectiveness of two methods of integration (full and partial) of urban leprosy services in terms of early case detection and regularity of treatment this study was conducted, in an urban area. Two townships with similar leprosy prevalence, staff infrastructure, socio-economic status, transport, communication and working capacity of the Township Medical Officers (TMOs) were chosen for this intervention study: UHC-A(Thingangyun) for full integration and UHC-B(Tamwe) for partial integration and the remaining 14 townships as non-integrated areas served by the Central Special Skin Clinic (CSSC). This study has shown that it was possible to fully integrate Leprosy Control Programme (LCP) into the Urban Health Centres [Basic Health Services (BHS)] in Urban Yangon. Case detection could be improved by active case finding such as contact examination and school examination conducted by the personnel of UHCs. Treatment regularity was found to be directly proportional to prompt defaulter retrieval action and the motivational level of the TMO and peripheral BHS workers. There were more complaints from patients (8.1%) treated at UHC-A when compared to CSSC (6.7%). Among defaulters there were more adults than children, more males than females and more PB than MB patients.