Factors affecting contact tracing for the early detection of Leprosy cases: A qualitative study in Ho, Volta Region, Ghana

Abstract

Introduction Despite Ghana being at the elimination phase of Leprosy, new cases of Leprosy are recorded in the country annually. These cases are usually detected in the advanced stages when Grade 2 disabilities (G2D) have set in. The WHO regards high G2D rates as an indication that measures need to be taken especially with regard to early detection. Late detection of cases raises concern about the spread of the infection. Contact tracing of index cases of Leprosy is therefore key in containing the spread. If the current situation is left unattended, Ghana faces the challenge of retrogressing in its fight against Leprosy. The general objective is to explore the factors affecting contact tracing for early case detection of Leprosy. Methods This study employed a qualitative research methodology. Specifically, the study adopted the phenomenology study design. Maximum variation purposive sampling technique was used for people affected by Leprosy who were either on treatment at the Ho Polyclinic or had completed treatment, health workers of the Polyclinic and community members at Ho, in the Volta Region of Ghana. Data was collected using in-depth interviews and focus group discussions among selected participants. All IDIs and FGDs were audio-recorded and transcribed verbatim. The data was coded using NVivO version 14 and analysed thematically. Results The results of this study showed that a majority of the community members and people affected by Leprosy perceived that Leprosy is caused by supernatural forces and hence the disease is not transmissible. Factors such as the stigma associated with the disease, reliance on divine forms of healing, use of herbs and poor symptom recognition hinder early detection. The study also revealed gaps in contact tracing efforts such as the inadequacy of funds for contact tracing as well as the reluctance of some contacts to be involved in the process. Conclusion The study concluded that both community and health system factors affect early detection of Leprosy cases in Ho. This has the potential to undermine Ghana's quest to eliminate Leprosy. There is a need to increase awareness of the importance of contact tracing for early detection of Leprosy.