Leprosy control in the post leprosaria abolition years in Nigeria: Reasons for default and irregular attendance at treatment centers

Nwosu, MC; Nwosu, Snn

doi:10.4314/wajm.v21i3.28025

Cited by 4 publications

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“…In fact, these logistical problems occurred mainly on the municipality level, as MDT provided by the State Leprosy Control Program to the municipalities did not suffer any shortage in the study period (A.C.F., unpublished observation). In other countries and settings, where leprosy control programs are not yet well established, such as in northern Mozambique, Nigeria and Sudan, health-service related factors play a more crucial role [4] , [7] , [18] , [19] , [22] .…”

Section: Discussionmentioning

confidence: 99%

Interruption and Defaulting of Multidrug Therapy against Leprosy: Population-Based Study in Brazil's Savannah Region

et al. 2011

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BackgroundLow adherence to multidrug therapy against leprosy (MDT) is still an important obstacle of disease control, and may lead to remaining sources of infection, incomplete cure, irreversible complications, and multidrug resistance.Methodology/Principal FindingWe performed a population-based study in 78 municipalities in Tocantins State, central Brazil, and applied structured questionnaires on leprosy-affected individuals. We used two outcomes for assessment of risk factors: defaulting (not presenting to health care center for supervised treatment for >12 months); and interruption of MDT. In total, 28/936 (3.0%) patients defaulted, and 147/806 (18.2%) interrupted MDT. Defaulting was significantly associated with: low number of rooms per household (OR = 3.43; 0.98–9.69; p = 0.03); moving to another residence after diagnosis (OR = 2.90; 0.95–5.28; p = 0.04); and low family income (OR = 2.42; 1.02–5.63: p = 0.04). Interruption of treatment was associated with: low number of rooms per household (OR = 1.95; 0.98–3.70; p = 0.04); difficulty in swallowing MDT drugs (OR = 1.66; 1.03–2.63; p = 0.02); temporal non-availability of MDT at the health center (OR = 1.67; 1.11–2.46; p = 0.01); and moving to another residence (OR = 1.58; 95% confidence interval: 1.03–2.40; p = 0.03). Logistic regression identified temporal non-availability of MDT as an independent risk factor for treatment interruption (adjusted OR = 1.56; 1.05–2.33; p = 0.03), and residence size as a protective factor (adjusted OR = 0.89 per additional number of rooms; 0.80–0.99; p = 0.03). Residence size was also independently associated with defaulting (adjusted OR = 0.67; 0.52–0.88; p = 0.003).ConclusionsDefaulting and interruption of MDT are associated with some poverty-related variables such as family income, household size, and migration. Intermittent problems of drug supply need to be resolved, mainly on the municipality level. MDT producers should consider oral drug formulations that may be more easily accepted by patients. Thus, an integrated approach is needed for further improving control, focusing on vulnerable population groups and the local health system.

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Section: Discussionmentioning

confidence: 99%

Interruption and Defaulting of Multidrug Therapy against Leprosy: Population-Based Study in Brazil's Savannah Region

et al. 2011

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“…Table 2 depicts the comparative studies of irregularity among leprosy patients by several authors in India and abroad. Although these periodic studies indicated that the reasons for irregularity are different in different regions [25][26][27][28][29][30][31][32][33][34][35] , India continues to be one of the endemic countries with new case detection rates ranging from 0.5% to 20%. New case detection rates have decreased and this could be attributed to the better control due to multi-drug therapy and decreased transmission of M.leprae, with new cases dominated by a long period of incubation, in the lepromatous leprosy cases [36] .…”

Section: Discussionmentioning

confidence: 99%

Leprosy Patients Attending the Out Patientâ€™s Clinic at Agra: A Retrospective Analysis of the Characteristics and Frequency of Regularity VS Irregularity for Determining Absenteeism, Non-adherence and Non-compliance

Yadav¹,

Katoch²,

Hussain³

2007

American J. of Infectious Diseases

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This study reports a retrospective analysis of the records of 2709 leprosy patients, attending the Out patient's Clinic at Agra, over a 1-year period, 2005. The patients with leprosy have been categorized into three groups, viz., regular, irregular and the drop-outs. The number of drop-out patients was significantly higher [Z=2.16, p=0.05] among males, 32.14% (667) when compared with females, 26.50% (168). Religion was not observed to be a significant determinant in the regularity, irregularity and/or drop-out among the patients but the locality/residential background seemed to play a key role in Clinic attendance. Patients from urban areas were less regular 38.9% (218) and the number of irregulars and drop-outs were more, i.e., 24.1% (135) and 37% (207), respectively when compared with the patients from rural areas [X 2 =14.894, p=0.00006]. Pauci-bacillary or multibacillary type of leprosy did not appear to be a significant determinant in the regularity, irregularity and / or drop-out among the patients. With regard to the various professions, the number of irregulars and drop-outs among patients engaged in some kind of business seemed to be more. The patients in whom the disease had become inactive, 69.7% (60) seemed to be more regular in clinic attendance than the patients with active leprosy disease. The irregularity and drop-out rate was significantly less [X 2 =5.107, p=0.078]. In all, 1226 (45.26%) patients were found to be regular in clinic attendance but 648 (23.92%) patients were irregular and 835(30.83%) patients were dropouts. The present study looked at the characteristics and factors responsible for irregular attendance of a large number of patients over a 1-year period, even after 50 years of implementation of the Leprosy Control/elimination programmes. This study is the first of its kind in Northern India.

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“…On April 11, responding to this controversy, the Nigerian government said it wanted to learn and the experts to share how they were able to contain the virus in their country and also revealed that the Nigerian medical team would engage with the Chinese experts through video conferencing while they were in quarantine. It claimed the importation of Chinese experts was a gesture from Chinese companies working in Nigeria, which also included 1.5 million dollars worth of medical supplies (Nwosu 2020).…”

Section: The Controversy Of the Imported Chinese Medical Teammentioning

confidence: 99%

Political confrontations and disagreements in the Nigerian Government’s COVID-19 response

Ijaiya

2023

MKP

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The COVID-19 outbreak has led to various interventions and policies from governments around the world, including Nigeria. However, Nigeria’s response was laden with political interests, confrontation and disagreements from various blocs of interest. Therefore, this study aims to examine various phenomena of political confrontation and disagreement during COVID-19 intervention. This study uses qualitative methods. Data were obtained through qualitative secondary data and analyzed thematically. The results of this study indicate that the People’s Democratic Party (PDP) and the All Progressive Congress (APC) are the two political parties that engage in the most political confrontation and disagreement. This study found that conflicting interests also occurred between the government and several interest groups regarding the import of foreign health workers and the distribution of COVID-19 assistance. Similarly, disagreements also ensued between the federal government and some subnational governments over their refusal to acknowledge the existence and/or severity of COVID-19. This study concludes that political conflicts and disagreements during COVID-19 in Nigeria were caused by government policies and interventions that could not be separated from competing interests and needs of the political, business, and professional elite.

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Leprosy control in the post leprosaria abolition years in Nigeria: Reasons for default and irregular attendance at treatment centers

Cited by 4 publications

References 0 publications

Interruption and Defaulting of Multidrug Therapy against Leprosy: Population-Based Study in Brazil's Savannah Region

Interruption and Defaulting of Multidrug Therapy against Leprosy: Population-Based Study in Brazil's Savannah Region

Leprosy Patients Attending the Out Patientâ€™s Clinic at Agra: A Retrospective Analysis of the Characteristics and Frequency of Regularity VS Irregularity for Determining Absenteeism, Non-adherence and Non-compliance

Political confrontations and disagreements in the Nigerian Government’s COVID-19 response

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