03007nas a2200217   4500000000100000008004100001260001100042100001400053700001300067700001300080700001700093700001500110700001300125700001400138700001600152245007500168856025600243490000700499520226900506022001402775       2022                            d  bIJSBAR1 aMartins N1 aGusmao C1 aViegas O1 aSarmento JCJ1 ada Costa F1 aSoares D1 aAfliana L1 a da Silva V00aContributing Factors to the Resurgence of Leprosy Cases in Timor-Leste  uhttps://www.researchgate.net/profile/Domingos-Soares/publication/363453268_Contributing_Factors_to_the_Resurgence_of_Leprosy_Cases_in_Timor-Leste/links/631c9f56071ea12e3622a07d/Contributing-Factors-to-the-Resurgence-of-Leprosy-Cases-in-Timor-Leste.pdf0 v633 a<p>Leprosy is a chronic, ancient, and communicable disease caused by Mycobacterium leprae (M. leprae), can damage skin and peripheral nerves. In 1991, the 44th World Health Assembly set a target for the elimination of leprosy from the world as a public health problem by 2000. Elimination was defined as a prevalence of less than 1 case per 10 000 populations. In 2019 WHO report reveal only 200 000 Leprosy cases were reported from 118 countries. Timor Leste declared elimination of Leprosy as Public Health Problem in 2011, but soon after that Leprosy cases were increased again. New case detection rate increased from 6.3 (2012) to 8.1 per 100,000 (2019). The Majority (86,7%) of new cases were reported from 5 municipalities of Oecusse, Baucau, Dili, Manatuto, Ainaro. Objectives: We conducted this study to identify contributing factors to the resurgence of Leprosy cases in the four Municipalities of Timor Leste. Cross-sectional Study with quantitative analytical approaches was used for this study. We enrolled 403 participants from 12 Community Health Centers in the 4 municipalities that reported high prevalence of Leprosy cases. About 68.5% of participants interviewed reported Leprosy cases, being male, mostly affected productive ages group, and with unknown income. Three health system components of stewardship, ICT, and Services Delivery were found to be associated with the resurgence of Leprosy cases. Delaying in making decision and delaying in accessing Leprosy care were contributing to the increased of Leprosy cases in the community. Leprosy patients experience high level of stigma and received less family and community support. Strengthening the active case finding with bacteriological confirmation by trained health professional; early commencing Rifampicin Preventive Therapy for close contacts; and engaging family and community in health promotion on Leprosy are important recommendations derived from this study. This study was conducted from September 1 to December 31, 2021 and enrolled 403 participants. About 68.5% of participants reported Leprosy cases in the community. Stewardship, Financial, ICT; and delays in making decision to visit health facilities were associated the resurgence of Leprosy cases in Timor-Leste.</p>
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