02495nas a2200133   4500000000100000008004100001260004000042245013200082856006200214300001000276490008000286050001400366520198100380       2008                            d  bRoyal Tropical InstituteaAmsterdam00aOn factors contributing to differences in new leprosy cases detected in Adamawa State, Nigeria : Focus on Koma and Za districts  uhttps://bibalex.org/baifa/Attachment/Documents/185302.pdf  a76 p.0 vMaster of Public Health / International Course in Health Development (ICHD)  aJOHN2008t3 aNigeria achieved the WHO elimination target for leprosy in 1998, however, pockets of high endemic areas exist. Adamawa State leprosy statistics showed that Jada, one of its 21 LGAs, has persistently been detecting high numbers of new leprosy cases from 2002 – 2006; Koma, one of the 11 districts of Jada LGA, contributed 70% of the new leprosy cases detected in Jada LGA during this period, despite continuous leprosy control interventions by the programme. The need to investigate factors contributing to the high case detection in Koma district is the focus of a research conducted in 2007 in Koma and Za districts on which this thesis is based. Piot model was adopted and used to describe factors influencing leprosy case detection. In order to appreciate these factors in Koma district of Jada LGA, a comparison is made with Za district of Michika LGA which shares similar demographic and geographic features with Koma but detects lower numbers of leprosy cases from 2002 – 2006. A cross sectional study was done comparing the 2 districts; 18 leprosy patients were interviewed, 4 FGDs were held and 11 GHCWs were assessed on leprosy in the 2 districts. Records of 132 leprosy patients who were treated from 2002 – 2006 in the 2 districts was analyzed. Findings include poor knowledge of GHCWs and irregular health education of leprosy patients on leprosy by GHCWs in both districts, worse in Koma in comparison to Za district; poor knowledge and awareness on leprosy among leprosy patients from both districts; misconceptions about leprosy and stigma towards patients, worse in Koma in comparison to Za; poor accessibility of leprosy services in Koma compared to Za and high influence of traditional healers in Koma district. Recommendations include the need to review the leprosy programmes’ health education messages and create more awareness, produce a curriculum to train GHCWs on counseling of leprosy patients and training of GHCWs and volunteers from the.