Empowerment of Communities in the Promotion ofPrevention of Disability (POD) for Persons Affectedby Leprosy in Tanzania

摘要

Objective: The ‘Prevention of Disability (POD) project for persons affected byleprosy’ was designed to strengthen early diagnosis through communityempowerment in high endemic districts in Tanzania and to reduce occurrence ofleprosy related Grade 2 disabilities.Methods: The project activities were implemented in leprosy high endemic districtswith prevalence rates above 1/10,000 population between 2012–2015. 12 districtswere involved and 12 new POD Committees with 236 POD members were trained tobe trainers. The POD committees trained 100 village health committees with 1,300members using the POD training manual under the supervision of District SocialWelfare Officers [SWOs] and District Tuberculosis and Leprosy Coordinators[DTLCs].Results: A total of 134,104 people were reached with 65,827 school children from225 schools and 68,277 adults from 248 villages. Through sensitisation activitiesinvolving district POD committees, village health committees, drama groups andcommunity members, 3,483 leprosy suspects were identified and 531 were confirmedby DTLCs as new leprosy cases. Through active case finding activities in householdcontacts 1399 contacts were reached and 73 new leprosy cases were confirmed.Conclusions: Statistics over the last 14 years showed that there was a decreasing ofnew leprosy cases notifications during routine passive cases finding period. With start of empowerment of community and household screening activities, the numbers of new cases in the districts increased tremendously. This suggests that there is a high presence of hidden cases. The numbers of new detected cases were in some districts more than doubled by the interventions. The relative low percentage of Grade 2 disability of 9% in the project compared to a current national average of over 12% support the effectiveness of the intervention ‘empowerment of communities’ for early case detection.