背景:新诊断的麻风病病例中,高比例的多杆菌(MB)构成了公共卫生挑战。
目的:本研究旨在找出西孟加拉邦MB麻风病高负担的相关因素。
方法:本病例对照研究于2020年8月至2022年12月在西孟加拉邦三个高流行区(年度新病例检出率≥10/10万)进行。
目的:根据国家麻风病根除计划注册的MB病例被视为病例,而小杆菌(PB)病例被视为对照。使用简单随机抽样从注册的麻风病患者列表中选择三个地区中每个地区的病例和对照的加权样本量。通过在孟加拉语中使用经过验证的问卷进行结构化访谈来收集必要数据。R,4.1.1版(R统计计算基金会,2021年,维也纳,奥地利)用于数据分析。以麻风病类型为因变量,建立二元逻辑回归模型。
结果:三百九十八人,204MB和194PB,参加了这项研究,无应答率为1.97%。性别,婚姻状况,和诊断延迟(调整比值比=2.75[1.66,4.65])与MB的发展相关.未发现严重症状(90,56%[PB],97,51%[MB]),缺乏对这种疾病及其并发症的了解(47%,29%[PB],53,28%[MB]),私人从业者延迟转介(11,7%[PB],22,12%[MB])是延迟的主要原因。
结论:这项研究确定了一个脆弱群体-已婚和迁徙男性。从年度筛查转变为季度筛查,以及目标人群的能力建设和意识培养,是根除这种疾病的必要时刻。
BACKGROUND: High proportion of multibacillary (MB) among newly diagnosed leprosy cases poses a public health challenge.
OBJECTIVE: This study aimed to find out the factors associated with the high burden of MB leprosy in West Bengal.
METHODS: This case-control study was conducted from August 2020 to December 2022 in three high-endemic districts (annual new case detection rate ≥10/lakh) of West Bengal.
OBJECTIVE: MB cases registered under the National Leprosy Eradication Programme were considered as case and paucibacillary (PB) cases were considered as control. Weighted sample sizes for cases and controls in each of the three districts were selected using simple random sampling from the list of registered leprosy patients. Requisite data were collected through structured interview with a validated questionnaire in Bengali. R, version 4.1.1 (R Foundation for Statistical Computing, 2021, Vienna, Austria) was used for data analysis. A binary logistic regression model was prepared with the type of leprosy as a dependent variable.
RESULTS: Three hundred and ninety-eight individuals, 204 MB and 194 PB, participated in this study with 1.97% nonresponse rate. Gender, marital status, and diagnostic delay (adjusted odds ratio = 2.75 [1.66,4.65]) were associated with developing MB. Not perceiving the symptoms seriously (90, 56% [PB], 97, 51% [MB]), lack of knowledge about the disease and its complications (47, 29% [PB], 53, 28% [MB]), delayed referral by the private practitioners (11, 7% [PB], 22, 12% [MB]) were the major reasons of delay.
CONCLUSIONS: This study identified a vulnerable group - married and migrated males. Changing from annual screening to quarterly screening along with capacity building and awareness generation of the targeted population is the need of the hour for eradicating the disease.