Improvement of early case detection of leprosy in Sichuan province, P. R. China
Document type: mthesis
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183338 (1741 KB)
Abstract:
The objective of this thesis is to generate the optimal and feasible strategies to improve early case detection in Sichuan province. Several major study questions are addressed in this thesis: “what factors contribute to delayed case detection?”, “how can Geographic Information System (GIS) help early case detection?” and “how to improve early case detection?”. In this descriptive exploratory study, several study methods are used, such as literature review, a problem tree analysis, the 3 Delay model of health seeking behaviour, and the techniques of GIS, scan statistic and probability mapping. There are a number of reasons that contribute to delayed case detection in leprosy. Lack of awareness about leprosy among the public, cultural beliefs, stigma and discrimination, gender inequities and poverty cause delays of health seeking of leprosy patients; loss of interest of the government, misdiagnosis in general health services, an underdeveloped referral system and less active case detection contribute to the delay within the health system; Lastly, geographical barriers and underdeveloped transportation in remote mountainous areas also lead to delay. Experiences from other provinces of China and other leprosy-endemic countries, literature review and analysis on leprosy case detection methods indicate that application of GIS would provide new opportunities for leprosy control, especially early case detection. Meanwhile, a leprosy GIS database of routine epidemiological data of Sichuan province (2002-2008) was established by use of ArcGIS 9.3 software. Three spatial-temporal clusters of new cases were identified through application of SatScan 8.0 software. A probability map at district level was made to analyze the disability situation in Sichuan province. In the context of the overall low-endemic situation, with limited resource allocation, the following are likely to be cost-effective and feasible strategies to improve early case detection of leprosy in Sichuan province: political commitment on early case detection, initiation of GIS at provincial level, encouraging voluntary reporting, strengthening contact examination, proper application of “clue survey”, short Suspect&Refer training of general health workers, professional training of dermatologists and leprosy health staff, health education of the public through mass media, reinforcing community participation, involvement of people affected by leprosy and promoting integration.
Authors:
Liu, Y.
Country:
China
Category:
Research
Department:
Development Policy & Practice
Institute:
KIT (Royal Tropical Institute)
Keywords:
health services
,
disease prevention and control
Language:
eng
Organization:
KIT - Royal Tropical Institute
PAGE:
vi, 51
Year:
2009
Region:
East Asia
Right:
© 2009 Liu
Subject:
Health and Nutrition
Title:
Improvement of early case detection of leprosy in Sichuan province, P. R. China
Training:
Master of Public Health / International Course in Health Development (ICHD)