Acceptability of contact screening and single dose rifampicin as chemoprophylaxis for leprosy in Dadra and Nagar Haveli, India

Authors: Apte H, Chitale M, Das S, Manglani PR, Mieras L.

Source: Leprosy review. 2019;90(1)31-45.

Summary

Single-dose rifampicin as post-exposure prophylaxis (SDR-PEP) for leprosy given to contacts of leprosy patients was proven to reduce their risk by 57%.1 The Leprosy Post-Exposure Prophylaxis (LPEP) program evaluates the feasibility of integrating SDR-PEP distribution into leprosy control programmes in eight leprosy endemic countries, among which India is one. Acceptability by the main stakeholders is an important component of feasibility and essential for sustainability and scale-up of health interventions. This study looked at the acceptability of the introduction of SDR-PEP in the LPEP project area in India. Study design: The acceptability of the implementation of the LPEP project was assessed in the Union Territory of Dadra and Nagar Haveli (DNH) in India. This was done through a qualitative cross-sectional study using semi-structured interviews and focus group discussions with the main stakeholders of the intervention. A quantitative component of the study was the compliance rate of index patients and their contacts in accepting contact screening and SDR-PEP administration. Results: The intervention was generally regarded as beneficial. Participants understood that SDR-PEP prevents the development of leprosy. Disclosure of the leprosy status of patients was needed to approach their close contacts. This was not a barrier for the administration of SDR-PEP. The trust in the health services, health staff and the gender sensitive approach contributed importantly to the high level of acceptability. The compliance rate was 99·0% among leprosy patients and 98·6% among contacts. Conclusion: Contact screening and SDR-PEP distribution in DNH, India, has been very well accepted by the main stakeholders: index patients, contacts, health workers and supervisors.