Epidemiological Characteristics and risk factors of leprosy in Terego, Koboko and Nebbi Districts in West Nile Region. A Cross sectional study.
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Background: Leprosy was eliminated in Uganda as public health problem for now over 30 years. However, new leprosy patients are still being reported in Uganda annually especially in West Nile region compared to other parts of the country. The study was to investigate the rise in leprosy cases in West Nile region of Uganda, understand leprosy transmission and inform the development of targeted interventions to reduce the burden of disease.
Methods: This was cross sectional study to analyse data from all leprosy patients reported in the health facilities in Koboko, Terego and Yumbe Districts. Data collection and physical examinations for all the reported leprosy reported from 2020 to 2023 was conducted. Descriptive statistics and Q-GIS v3.22.5 was used to generate maps highlighting areas of potential interest.
Results: A total of 525 (207 in Terego, 185 – Koboko and 133 for Nebbi) patients were reported from 2020 to 2023. Overall 66% of the case patients were females across the three districts. (69% in Koboko, 58% in Terego and 62% in Nebbi.) The mean age was 38 years (Mode 40 SD 14) and the proportion of child leprosy patients was 14.5%. Majority (93%) of the leprosy patients were Nationals peasant farmers (82%) with 96% having Multi-bacillary leprosy. The median time for symptom onset prior to diagnosis among the patients was 26 months. Terego district reported the biggest (33%) proportion of leprosy patients having grade 2 disability at the time of diagnosis. The risk factors for leprosy among the patients included poverty and being a contact. Leprosy surveillance in West Nile is mainly (86%) passive. However, targeted surveys as well as Contact surveillance is periodically done.
Conclusion: A total of 525(185- Koboko, 133- Nebbi and 207- Terego) patients were reported from 2020 to 2023. There were more females (58%) leprosy patients reported in all the three districts. The proportion of children below 15years was 14% and 33(5.3%) had grade 2 disabilities at the time of diagnosis. Majority (93%)of the patients were nationals. The sub counties with the highest number of leprosy patients reported were Angal , Lobule and Odupe for Nebbi Koboko and Terego respectively . There was limited leprosy case finding in the communities and suboptimal integration of leprosy work into the rest of the district and health facility activities with a significant number of health care workers having limited knowledge and skills in diagnosis and Disability grading.
Recommendation: There is need for sustained contact tracing and administration of leprosy post exposure prophylaxis to those that are eligible. Heightened health education on leprosy, provision of IEC materials and training of health workers as well as continued mentorship is also recommended. Deeper integration of leprosy into other health programs is also recommended e.g. School Health program and integrated management of Childhood Illnesses.