In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 16, No. 10 ( 2022-10-17), p. e0010792-
Abstract:
In the past 15 years, the decline in annually detected leprosy patients has stagnated. To reduce the transmission of Mycobacterium leprae , the World Health Organization recommends single-dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients. Various approaches to administer SDR-PEP have been piloted. However, requirements and criteria to select the most suitable approach were missing. The aims of this study were to develop an evidence-informed decision tool to support leprosy programme managers in selecting an SDR-PEP implementation approach, and to assess its user-friendliness among stakeholders without SDR-PEP experience. Methodology The development process comprised two phases. First, a draft tool was developed based on a literature review and semi-structured interviews with experts from various countries, organisations and institutes. This led to: an overview of existing SDR-PEP approaches and their characteristics; understanding the requirements and best circumstances for these approaches; and, identification of relevant criteria to select an approach. In the second phase the tool’s usability and applicability was assessed, through interviews and a focus group discussion with intended, inexperienced users; leprosy programme managers and non-governmental organization (NGO) staff. Principal findings Five SDR-PEP implementation approaches were identified. The levels of endemicity and stigma, and the accessibility of an area were identified as most relevant criteria to select an approach. There was an information gap on cost-effectiveness, while successful implementation depends on availability of resources. Five basic requirements, irrespective of the approach, were identified: stakeholder support; availability of medication; compliant health system; trained health staff; and health education. Two added benefits of the tool were identified: its potential value for advocacy and for training. Conclusion An evidence-informed SDR-PEP decision tool to support the selection of implementation approaches for leprosy prevention was developed. While the tool was evaluated by potential users, more research is needed to further improve the tool, especially health-economic studies, to ensure efficient and cost-effective implementation of SDR-PEP.
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0010792
DOI:
10.1371/journal.pntd.0010792.g001
DOI:
10.1371/journal.pntd.0010792.g002
DOI:
10.1371/journal.pntd.0010792.g003
DOI:
10.1371/journal.pntd.0010792.t001
DOI:
10.1371/journal.pntd.0010792.t002
DOI:
10.1371/journal.pntd.0010792.t003
DOI:
10.1371/journal.pntd.0010792.s001
DOI:
10.1371/journal.pntd.0010792.s002
DOI:
10.1371/journal.pntd.0010792.s003
DOI:
10.1371/journal.pntd.0010792.s004
DOI:
10.1371/journal.pntd.0010792.s005
DOI:
10.1371/journal.pntd.0010792.s006
DOI:
10.1371/journal.pntd.0010792.r001
DOI:
10.1371/journal.pntd.0010792.r002
DOI:
10.1371/journal.pntd.0010792.r003
DOI:
10.1371/journal.pntd.0010792.r004
DOI:
10.1371/journal.pntd.0010792.r005
DOI:
10.1371/journal.pntd.0010792.r006
DOI:
10.1371/journal.pntd.0010792.r007
DOI:
10.1371/journal.pntd.0010792.r008
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2429704-5
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