A practical method of active case finding and epidemiological assessment: its origin and application in the leprosy control project in Indonesia
Louhenapessy, A.A.; Zuiderhoek, B.
International Journal of Leprosy and other Mycobacterial Diseases Official Organ of the International Leprosy Association 65(4): 487-491
1997
ISSN/ISBN: 0148-916X PMID: 9465159 Document Number: 200619
A leprosy case finding pilot project carried out in Indonesia's Bantimurung subregency in 1977 identified 48 indeterminate/tuberculoid and 62 borderline/lepromatous cases in a population of 40,000. The majority of these individuals wanted treatment, but were reluctant to visit a health center because of the associated social stigma. As a result of these findings, the government decided to reintroduce exploration surveys to the South Sulawesi Province. Such chase or trace surveys are conducted within the framework of the leprosy workers' routine duties. To overcome stigma and convince residents to present for examination, local authorities conducted health education campaigns. In the course of chase surveys in the province's 155 subregencies (population, 4,960,000), 6280 new cases were detected, many of which had been present for a year or more. A random sample survey conducted in the Bone Regency immediately after the chase surveys (in which 1492 cases were detected) revealed an average rate of 6.7/1000 still undetected paucibacillary cases and 0.2/1000 multibacillary cases. Although chase surveys cannot provide the in-depth data generated by random sample surveys, especially in areas of high endemicity, they have greatly increased the number of leprosy cases detected and treated in Indonesia.