scholarly journals Development of a questionnaire to determine the case detection delay of leprosy: A mixed-methods cultural validation study

2022 ◽  
Vol 16 (1) ◽  
pp. e0010038
Author(s):  
Naomi D. de Bruijne ◽  
Kedir Urgesa ◽  
Abraham Aseffa ◽  
Kidist Bobosha ◽  
Anne Schoenmakers ◽  
...  
Keyword(s):  
Large Scale ◽  
Health Workers ◽  
Post Exposure Prophylaxis ◽  
Case Detection ◽  
Cultural Validity ◽  
Detection Delay ◽  
Leprosy Case ◽  
The Moment ◽  
Exposure Prophylaxis ◽  
Test Retest Reliability

Background Delay in case detection is a risk factor for developing leprosy-related impairments, leading to disability and stigma. The objective of this study was to develop a questionnaire to determine the leprosy case detection delay, defined as the period between the first signs of the disease and the moment of diagnosis, calculated in total number of months. The instrument was developed as part of the PEP4LEP project, a large-scale intervention study which determines the most effective way to implement integrated skin screening and leprosy post-exposure prophylaxis with a single-dose of rifampicin (SDR-PEP) administration in Ethiopia, Mozambique and Tanzania. Methodology/Principal findings A literature review was conducted and leprosy experts were consulted. The first draft of the questionnaire was developed in Ethiopia by exploring conceptual understanding, item relevance and operational suitability. Then, the first draft of the tool was piloted in Ethiopia, Mozambique and Tanzania. The outcome is a questionnaire comprising nine questions to determine the case detection delay and two annexes for ease of administration: a local calendar to translate the patient’s indication of time to number of months and a set of pictures of the signs of leprosy. In addition, a body map was included to locate the signs. A ‘Question-by-Question Guide’ was added to the package, to provide support in the administration of the questionnaire. The materials will be made available in English, Oromiffa (Afaan Oromo), Portuguese and Swahili via https://www.infolep.org. Conclusions/Significance It was concluded that the developed case detection delay questionnaire can be administered quickly and easily by health workers, while not inconveniencing the patient. The instrument has promising potential for use in future leprosy research. It is recommended that the tool is further validated, also in other regions or countries, to ensure cultural validity and to examine psychometric properties like test-retest reliability and interrater reliability.

scholarly journals Leprosy Post-Exposure Prophylaxis (LPEP) programme: study protocol for evaluating the feasibility and impact on case detection rates of contact tracing and single dose rifampicin

BMJ Open ◽  
2016 ◽  
Vol 6 (11) ◽  
pp. e013633 ◽  
Author(s):  
Tanja Barth-Jaeggi ◽  
Peter Steinmann ◽  
Liesbeth Mieras ◽  
Wim van Brakel ◽  
Jan Hendrik Richardus ◽  
...  
Keyword(s):  
Single Dose ◽  
Study Protocol ◽  
Contact Tracing ◽  
Post Exposure Prophylaxis ◽  
Case Detection ◽  
Detection Rates ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals “As long as the patient tells you it was a dog that bit him, why do you need to know more?” A qualitative study of how healthcare workers apply clinical guidelines to treat dog bite injuries in selected hospitals in Uganda

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254650
Author(s):  
Stevens Kisaka ◽  
Fredrick E. Makumbi ◽  
Samuel Majalija ◽  
Alexander Kagaha ◽  
S. M. Thumbi
Keyword(s):  
Clinical Guidelines ◽  
Clinical Management ◽  
Health Workers ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Dog Bites ◽  
Rabies Control ◽  
Exposure Prophylaxis ◽  
Control And Management ◽  
Bite Injuries

Dog-mediated rabies is on the increase in Uganda despite the availability of post-exposure prophylaxis (PEP). PEP procedures are expounded in the Uganda Clinical Guidelines (UCG) of 2016. We assessed adherence by health workers to UCG while managing dog bites in two PEP centers and obtained insights into motivations of their practices. Using qualitative methods, we observed the health worker-patient encounters, reviewed medical records, and interviewed 14 health workers that were involved in managing dog bite injuries. We used deductive thematic analysis to identify codes in themes developed from UCG. We found that much of the history of the bites was taken, but it was neither verified nor written down on the patient’s file. Classification of wounds was inaccurate and ancillary laboratory assessments like culture and sensitivity tests were not conducted in all cases. Although antibiotics were given for both treatment and prophylactic purposes, the prescription was based on availability and affordability, not UCG recommendations. Rabies immunoglobulin (RIG) was not administered to deserving patients due to unavailability and high costs to the patient. Anti-rabies vaccine (ARV) was prescribed indiscriminately and some health workers attributed this to pressure from patients. Health education regarding prevention of dog bites was not given to patients due to time constraints on the side of the providers as a result of high caseloads at the emergency departments. Challenges to adherence to guidelines were identified as frequent ARV stock outs; inadequate cooperation among health facilities; and insufficient knowledge and skills on how injuries and rabies should be managed. We conclude that clinical management of dog bites is not fully in line with UCG. We argue that adoption of an integrated bite case management and cost-saving strategies as well as continuing medical education programs on rabies control and management could improve the clinical management of dog bites.

scholarly journals Effectiveness Analysis of Single Dose Rifampicin-Post-Exposure Prophylaxis (SDR-PEP) as A Preventive Intervention for Leprosy Transmission: A Systematic Review of Randomized Controlled Trials

2021 ◽  
Vol 4 (2) ◽  
pp. 35-43
Author(s):  
Muhammad Mikail Athif Zhafir Asyura ◽  
Ilma Ranjani Wijaya ◽  
Theetouch Toshukowong ◽  
Rui Sheng Wang
Keyword(s):  
Systematic Review ◽  
Single Dose ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Preventive Intervention ◽  
Post Exposure Prophylaxis ◽  
Controlled Trials ◽  
Post Exposure ◽  
Randomized Controlled ◽  
Exposure Prophylaxis

Introduction: Leprosy is a skin disease that reaches 200,000 cases annually. Considered a neglected tropical disease, 80% of annual leprosy remained in countries such as Brazil, India, and Indonesia. Multi-drug treatment is effective in curing leprosy but ineffective in preventing further transmission. The implementation of large-scale single dose rifampicin-post exposure prophylaxis suggests the inhibition of leprosy transmission and thus needs validation.Methods: This systematic review was carried out based on the PRISMA statement from multiple databases using set keywords. A total of 646 studies were identified, followed by 4 randomized controlled trials included after screening.Results: 86,502 subjects were divided into control and interventional groups and were to be followed up in 2-6 years. Most studies showed a significant decrease of leprosy cases by 50-60%. Furthermore, a complementary effect between single-dose rifampicin-post exposure prophylaxis and Bacillus Calmette–Guérin vaccine was identified. Moreover, the cost-effectiveness of the intervention was analyzed which resulted in IDR 80,414,775 being averted in its 25th year of implementationConclusion: The review established promising results of implementing single dose rifampicin-post exposure prophylaxis to prevent leprosy transmission. Further national scale intervention with a multi-layered approach is suggested to ensure full support and continuity of the large-scale intervention 

scholarly journals Repurposing Approved Drugs for Guiding COVID-19 Prophylaxis: A Systematic Review

2020 ◽  
Vol 11 ◽  
Author(s):  
Bruno Silva Andrade ◽  
Fernanda de Souza Rangel ◽  
Naiane Oliveira Santos ◽  
Andria dos Santos Freitas ◽  
Wagner Rodrigues de Assis Soares ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Large Scale ◽  
Post Exposure Prophylaxis ◽  
Drug Candidates ◽  
Global Pandemic ◽  
The World ◽  
Approved Drugs ◽  
Exposure Prophylaxis

The SARS-CoV-2 outbreak originally appeared in China in December 2019 and became a global pandemic in March 2020. This infectious disease has directly affected public health and the world economy. Several palliative therapeutic treatments and prophylaxis strategies have been used to control the progress of this viral infection, including pre-(PrEP) and post-exposure prophylaxis. On the other hand, research groups around the world are still studying novel drug prophylaxis and treatment using repurposing approaches, as well as vaccination options, which are in different pre-clinical and clinical testing phases. This systematic review evaluated 1,228 articles from the PubMed and Scopus indexing databases, following the Kitchenham bibliographic searching protocol, with the aim to list drug candidates, potentially approved to be used as new options for SARS-CoV-2 prophylaxis clinical trials and medical protocols. In searching protocol, we used the following keywords: “Covid-19 or SARS-CoV-2” or “Coronavirus or 2019 nCoV,” “prophylaxis,” “prophylactic,” “pre-exposure,” “COVID-19 or SARS-CoV-2 Chemoprophylaxis,” “repurposed,” “strategies,” “clinical,” “trials,” “anti-SARS-CoV-2,” “anti-covid-19,” “Antiviral,” “Therapy prevention in vitro,” in cells “and” human testing. After all protocol steps, we selected 60 articles that included: 15 studies with clinical data, 22 studies that used in vitro experiments, seven studies using animal models, and 18 studies performed with in silico experiments. Additionally, we included more 22 compounds between FDA approved drugs and drug-like like molecules, which were tested in large-scale screenings, as well as those repurposed approved drugs with new mechanism of actions. The drugs selected in this review can assist clinical studies and medical guidelines on the rational repurposing of known antiviral drugs for COVID-19 prophylaxis.

scholarly journals Occupational exposure to HIV and use of post-exposure prophylaxis in a general hospital in North Central, Nigeria.

2013 ◽  
Vol 3 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Abiola O Olaleye ◽  
Olorunfemi A Ogundele ◽  
Babatunde I Awokola ◽  
Oladele S Olatunya ◽  
Omolara A Olaleye ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
General Hospital ◽  
Health Workers ◽  
Central Zone ◽  
Occupational Exposures ◽  
Post Exposure Prophylaxis ◽  
North Central ◽  
Post Exposure ◽  
Exposure Prophylaxis

Occupational exposures to blood borne pathogens including HIV have been well studied. However, limited studies exist about the utilization of post exposure prophylaxis and follow-up in Nigeria. The objectives of the study were to describe the characteristics of occupational exposure to HIV, the utilization of post exposure prophylaxis (PEP) among health workers, and the proportion of exposed health workers reporting for follow-up three months after exposure. A cross sectional descriptive study involving ninety three health workers was carried out at a general hospital located in an urban area in North Central zone of Nigeria. A simple random sampling technique was used. The prevalence of occupational exposure, utilization of post exposure prophylaxis and follow-up rate were assessed using self administered questionnaire. Data analysis was done using SPSS version 16 and descriptive analysis was carried out. It was reported that, 73.1% of respondents at least one or more occupational exposures to HIV and other blood borne pathogens through accidental needle injury/prick, blood splash on a fresh wound or conjunctiva exposure in the last one year. Needle stick injury occurred in 83.8% of all respondents who had occupational exposures. 8.8% of exposed respondents commenced post exposure prophylaxis with two-thirds completing the post exposure prophylaxis regimen. Only one (25%) of those who completed the regimen reported for follow-up. Occupational exposures to HIV are common among health workers. The rates of utilization of post exposure prophylaxis and follow-up were low.   DOI: http://dx.doi.org/10.3126/ijosh.v3i1.6635   International Journal of Occupational Safety and Health, Vol 3 No 1 (2013) 11-17

scholarly journals Surveillance to Establish Elimination of Transmission and Freedom from Dog-mediated Rabies

2016 ◽  
Author(s):  
Katie Hampson ◽  
Bernadette Abela-Ridder ◽  
Kirstyn Brunker ◽  
S. Tamara M. Bucheli ◽  
Mary Carvalho ◽  
...  
Keyword(s):  
Cost Effective ◽  
Contact Tracing ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Case Detection ◽  
Health Seeking ◽  
Canine Rabies ◽  
Freedom From Disease ◽  
Exposure Prophylaxis ◽  
Low Prevalence

AbstractBackgroundWith a global target set for zero human deaths from dog-mediated rabies by 2030 and some regional programmes close to eliminating canine rabies, there is an urgent need for enhanced surveillance strategies suitable for declaring freedom from disease and elimination of transmission with known confidence.MethodsUsing exhaustive contact tracing across settings in Tanzania we generated detailed data on rabies incidence, rabid dog biting behaviour and health-seeking behaviour of bite victims. Using these data we compared case detection of sampling-based and enhanced surveillance methodologies and investigated elimination verification procedures.FindingsWe demonstrate that patients presenting to clinics with bite injuries are sensitive sentinels for identifying dog rabies cases. Triage of patients based on bite history criteria and investigation of suspicious incidents can confirm >10% of dog rabies cases and is an affordable approach that will enable validation of disease freedom following two years without case detection. Approaches based on sampling the dog population without using bite-injury follow-up were found to be neither sensitive nor cost-effective.InterpretationThe low prevalence of rabies, and short window in which disease can be detected, preclude sampling-based surveillance. Instead, active case finding guided by bite-patient triage is needed as elimination is approached. Our proposed methodology is affordable, practical and supports the goal of eliminating human rabies deaths by improving administration of lifesaving post-exposure prophylaxis for genuinely exposed but untreated contacts. Moreover, joint investigations by public health and veterinary workers will strengthen intersectoral partnerships and capacity for control of emerging zoonoses.

scholarly journals Occupational exposures and utilisation of HIV postexposure prophylaxis amongst health workers of three hospitals in Tanzania’s Lake Zone

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Rogatus Kabyemera ◽  
Albino Kalolo ◽  
Geethika Fernando ◽  
Susan Bergson
Keyword(s):  
Health Workers ◽  
Occupational Exposures ◽  
Worker Safety ◽  
Future Research ◽  
Post Exposure Prophylaxis ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Exposure Prophylaxis ◽  
Needle Sticks

Occupational exposures predispose health workers (HWs) to a risk of HIV infection. When properly used, HIV Post Exposure Prophylaxis (PEP) can significantly reduce this risk. Th purpose of this study was to determine the extent and types of occupational exposures, availability of PEP guidelines, and utilisation of PEP amongst HWs. A cross-sectional mixed methods baseline study was conducted between March and May 2014 using a structured questionnaire administered to 236 HWs from Shinyanga, Sengerema and Musoma hospitals in Tanzania. Relationships between variables were determined using the chi-square test. Qualitative data was gathered during interviews with key informants and walkthrough observations in the hospital wards, and analysed using the framework method. Majority of respondents were nurses (53%), over 40 years old (61%) with more than 20 years (40%) of hospital experience. Needle stick and sharp injuries were experienced by 31% of respondents whilst 26% experienced splashes. Only 28% of splashes were reported compared to 80% and 68% of needle sticks and sharp injuries, respectively. Those who experienced needle sticks were more likely to report the incident (p < 0.001), receive testing (p < 0.003) or PEP (p = 0.005). Although 66% reported the availability of PEP guidelines, only 39% of exposed HWs received PEP. Occupational exposures are common in these hospitals. HWs under-report and suboptimally use PEP services. Health worker safety programmes should establish functional systems for reporting and adherence to PEP procedures. Future research should establish factors that determine compliance with PEP procedures.

scholarly journals OC 8244 QUANTITATIVE LATERAL FLOW ASSAY FOR DETECTION OF M. LEPRAE INFECTION USING FINGERSTICK BLOOD

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A2.3-A3
Author(s):  
Annemieke Geluk ◽  
Anouk Van Hooij ◽  
Elisa Tjon El Fat ◽  
Kosrhed Alam ◽  
Sipho Dlamini ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Bacterial Load ◽  
Lateral Flow ◽  
Added Value ◽  
Quantitative Detection ◽  
Post Exposure Prophylaxis ◽  
Test Strips ◽  
Leprosy Case ◽  
Risk Of Progression ◽  
Exposure Prophylaxis

BackgroundLeprosy is a debilitating, infectious disease caused by Mycobacterium leprae leading to skin and nerve damage and often lifelong handicaps. The unabated rate of new leprosy case detection indicates that transmission of M. leprae is persistent and that current measures for prevention and multidrug therapy (MDT) are insufficient. Contact with M. leprae-infected individuals is a risk factor for development of leprosy. Thus, detection of M. leprae-infected individuals without clinical symptoms, allowing informed decision making on who needs treatment at a preclinical stage, is vital to interrupt transmission and can help prevent leprosy.Immunoprophylaxis by vaccination or post-exposure prophylaxis (PEP) with antibiotics provide effective strategies for the prevention of leprosy. To target individuals unknowingly spreading leprosy bacilli, methods allowing objective measurement of M. leprae infection are needed. Besides antibody (Ab) levels that correspond with bacterial load and higher risk of progression to leprosy, detection of cytokine profiles can provide significant added value to identify infection.MethodsQuantitative detection of anti-PGL-I IgM antibodies, and cytokines such as IP-10 was performed on lateral flow (LF) test strips utilising the luminescent up-converting particle (UCP) technology. Precise amounts of fingerstick (FS)-blood samples were collected using disposable heparinised capillaries. Ab and cytokine levels in both FS-blood and serum from „leprosy patients in South-Africa, Brazil, Bangladesh and the Netherlands and (their) contacts were measured using a portable reader.ResultsExcellent correlation was demonstrated between data for anti-PGL-I IgM Ab and cytokines obtained with serum and FS blood from the same individuals.ConclusionThe quantitative UCP-LF test strips detecting anti-PGL-I IgM Ab and cytokines for the detection of M. leprae infection is compatible with fingerstick blood allowing near-patient testing and immediate appropriate follow-up counselling.

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