College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia.
Armauer Hansen Research Institute (AHRI), Addis Ababa, Ethiopia.
PLoS One. 2023 Jun 21;18(6):e0264100. doi: 10.1371/journal.pone.0264100. eCollection 2023.
Leprosy is a chronic mycobacterial disease of public health importance. It is one of the leading causes of permanent physical disability. The prevalence of leprosy in Ethiopia has remained stagnant over the last decades. The aim of the study was to identify new leprosy cases and trace household contacts at risk of developing leprosy by active case detection. The study area was Kokosa district, West Arsi zone, Oromia region, Ethiopia.
A prospective longitudinal study was conducted from June 2016-September 2018 at Kokosa district. Ethical approvals were obtained from all relevant institutions. Health extension workers screened households by house-to-house visits. Blood samples were collected and the level of anti-PGL-I IgM measured at two-time points.
More than 183,000 people living in Kokosa district were screened. Dermatologists and clinical nurses with special training on leprosy confirmed the new cases, and their household contacts were included in the study. Of the 91 new cases diagnosed and started treatment, 71 were recruited into our study. Sixty-two percent were males and 80.3% were multibacillary cases. A family history of leprosy was found in 29.6% of the patients with cohabitation ranging from 10 to 30 years. Eight new leprosy cases were diagnosed among the 308 household contacts and put on multi-drug therapy. The New Case Detection Rate increased from 28.3/100,000 to 48.3/100,000 between 2015/2016 and 2016/2017. Seventy one percent of leprosy patients and 81% of the household contacts' level of anti-PGL-I IgM decreased after treatment. In conclusion,the results of the study showed the importance of active case detection and household contact tracing. It enhances early case finding, and promotes early treatment, thereby interrupting transmission and preventing potential disability from leprosy.
麻风病是一种具有公共卫生重要性的慢性分枝杆菌病。它是导致永久性身体残疾的主要原因之一。在过去几十年中，埃塞俄比亚的麻风病患病率一直停滞不前。本研究的目的是通过主动病例发现来确定新的麻风病例并追踪有患麻风病风险的家庭接触者。研究区域为埃塞俄比亚奥罗米亚地区西阿尔西地区的科科萨区。
2016 年 6 月至 2018 年 9 月在科科萨区进行了一项前瞻性纵向研究。所有相关机构均获得了伦理批准。卫生推广工作者通过挨家挨户的走访对家庭进行筛查。采集血样并在两个时间点测量抗 PGL-I IgM 水平。
科科萨区有超过 183000 人接受了筛查。经过麻风病专门培训的皮肤科医生和临床护士确认了新病例，并将其家庭接触者纳入了研究。在确诊并开始治疗的 91 例新病例中，有 71 例被纳入我们的研究。71%为男性，80.3%为多菌型病例。29.6%的患者有麻风病家族史，同居时间从 10 年到 30 年不等。在 308 名家庭接触者中，有 8 例新的麻风病例被诊断出来并接受了多药治疗。2015/2016 年至 2016/2017 年期间，新病例检出率从 28.3/100000 增加到 48.3/100000。71%的麻风病患者和 81%的家庭接触者的抗 PGL-I IgM 水平在治疗后下降。总之，研究结果表明主动病例发现和家庭接触者追踪的重要性。它增强了早期病例发现，并促进了早期治疗，从而阻断了传播并防止了麻风病的潜在残疾。
