Acceptability and feasibility of chemoprophylaxis with single-dose rifampicin in four leprosy-endemic districts in Benin.

BACKGROUNDS

Chemoprophylaxis with single-dose rifampicin (SDR) is a preventive measure recommended by the World Health Organization to limit leprosy transmission. This study was carried out to assess the acceptability and feasibility of this measure in Benin.

METHODS

This intervention-oriented study, including contacts of people affected by leprosy (PALs), was conducted in two linear phases from September 2019 to August 2020 in Benin. In the first phase, we assessed contacts' knowledge of leprosy and their perceptions of SDR through interviews conducted after their informed consent. In the second phase, contacts were educated about leprosy and the importance of SDR in leprosy control. Eligible contacts were clinically examined, and new leprosy patients were treated with multidrug therapy while consented healthy contacts received the SDR.

RESULTS

9,941 contacts were registered around 197 PALs. After interviewing 394 contacts, the majority (88.8%) had insufficient leprosy knowledge. Of these contacts, 58.6% agreed to receive chemoprophylaxis. They were willing to take the necessary time for treatment (74.5%), travel long distances (83.1%) and take the drug as often as possible (90.0%). Marital status (p = 0.008), education level (p = 0.000) and knowledge of leprosy (p = 0.000) were statistically linked to chemoprophylaxis acceptance. Contacts who lived alone, who weren't educated and had little knowledge of leprosy were respectively 2.18, 2.75 and 43.13 times more likely to refuse chemoprophylaxis. Of the 9,941 sensitized contacts, 6,798 were clinically examined, and 6,416 received SDR. The average age of contacts who received chemoprophylaxis was 27.3 years (±19.8), with a predominance of women (52.7%). Eight (8) new patients were identified and treated with multidrug therapy.

CONCLUSION

It is important to increase awareness to improve knowledge of leprosy to contribute to chemoprophylaxis acceptance.