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Active surveillance in leprosy: how useful is it?
1Danish Bangladesh Leprosy Mission, Nilphamari, Bangladesh.
Leprosy Review
|June 1, 1996
Summary
Self-reporting is more effective than active surveillance for detecting nerve damage in leprosy patients post-multidrug therapy (MDT). Health education at release from treatment (RFT) motivates patients to report symptoms, making active surveillance less critical for nerve function loss detection.
Area of Science:
- Medical Research
- Public Health
- Epidemiology
Background:
- Leprosy patients completing multidrug therapy (MDT) require ongoing monitoring for nerve function loss.
- Traditional active surveillance methods may not be the most efficient for detecting new nerve damage post-treatment.
Purpose of the Study:
- To compare the effectiveness of active surveillance versus patient self-reporting in detecting new nerve function loss.
- To evaluate the impact of health education at release from treatment (RFT) on patient reporting of nerve damage.
Main Methods:
- A study involving 503 leprosy patients who completed MDT was conducted.
- Active surveillance and self-reporting of new nerve function loss were monitored over a 7-month period.
- Coverage for surveillance reached 71%.
Main Results:
- Ten patients experienced acute nerve damage requiring treatment.
- Only 2 of these 10 cases were detected through active surveillance.
- The remaining 8 cases were identified via self-reporting by patients.
- Health education at RFT was found to be effective in encouraging self-reporting.
Conclusions:
- Patient self-reporting, enhanced by health education at RFT, is a more effective strategy for detecting nerve function loss than active surveillance.
- Resources allocated to active surveillance could be redirected to other crucial activities like case detection.
- Active surveillance was subsequently abandoned in the leprosy control project based on these findings.