Feasibility of integrating systematic leprosy contact tracing and post exposure prophylaxis (PEP) into the routine leprosy control program in Uganda: A case study in Arua and Koboko districts

Background Recent new case numbers of leprosy in Uganda indicate that control activities are currently failing. Contact investigation and post exposure prophylaxis (PEP) given to eligible leprosy contacts are two major leprosy control strategies currently recommended to identify and manage exposed and at-risk contacts. This cross sectional study among contacts of leprosy patients was conducted to investigate the feasibility of integrating systematic contact tracing and PEP using Single Dose Rifampicin (SDR) into the routine leprosy control activities in two districts in Uganda. Method This was a mixed methods study in which we concurrently collected both quantitative and qualitative data, the findings of which were merged at the point of data analysis. Quantitative data were obtained using pre-designed survey tools and multiple sources of data were used to extract appropriate information, including: patient treatment cards, hospital and health facility registers and individual responses. Qualitative data were obtained in the form of focus group discussions with health workers, patients and their contacts. The study was approved by the Uganda national Council of Science and Technology. Results A total of 102 index cases participated in the study 60 (60%) being male. The mean age was 42 years with mean duration from first symptom to diagnosis being 32 months (range 1 month to 300 months, SD 47.4). All index cases accepted to be enrolled into the study and 379/382 (99.2%) eligible contacts accepted and took Single Dose Rifampicin (SDR). The number of new leprosy cases diagnosed amongst the contacts examined was six; all were adults and none had grade 2 disabilities. Conclusion Integration of leprosy contact management with administration of Single Dose Rifampicin is feasible and is generally well accepted by the index cases, their contacts and health care workers. We recommend that routine systematic contact management with administration of SDR-PEP should be integrated with routine services.