Operational barriers to the implementation of multidrug therapy and leprosy elimination in Cameroon.
BACKGROUND
The World Health Organization targeted to eliminate leprosy from the world with multidrug therapy (MDT) by 2000. But, leprosy remains a problem in Essimbiland of Menchum Division of Cameroon, with a prevalence of 1.7/10,000 and high rate of case detection in children.


OBJECTIVE
To assess knowledge and practices on the cure of leprosy, treatment duration, drug availability and problems faced by leprosy patients acquiring drugs in order to enhance MDT implementation and leprosy elimination in Menchum and Boyo divisions.


METHODS
Observational study in which a structured questionnaire was administered to leprosy patients, their contacts and a control group.


RESULTS
480 respondents were interviewed and 405 (84.8%) (95% confidence interval [CI]: 81.6-87.2%) knew that leprosy can be cured. These respondents comprised 166 (92.2%) of 180 contacts, 129 (93.5%) of 138 patients and 110 (67.9%) of 162 controls. Two hundred and fourteen (44.6%) (95% CI: 40.1-48.9%) respondents knew that leprosy treatment is free, comprising of 110 (51.4%) patients, 99 (46.3%) contacts and five (2.3%) controls. A statistically significant difference in the knowledge on free treatment of leprosy was found to exist between leprosy patients, contacts and controls, with leprosy patients having a better knowledge (79.71%) (95% CI: 73-86.42%), followed by contacts (55.0%) (95% CI: 47.73-62.26%) and controls (3.1%) (95% CI: 0.43-5.77%) (P = 0.00). Pertinent problems faced by patients in getting MDT included distant health facilities and poor road network (91[19.0%]), lack of confidence in treatment (56 [11.7%]), MDT shortage (45 [9.4%]), few health facilities (52 [10.8%]), gratification demands (25 [5.2%]), disturbance from other illnesses (24 [5.0]), ignorance (21 [4.4%]) and poor relationship with nurses (24 [5.0%]).


CONCLUSIONS
Patients still face problems in getting free MDT. Better MDT implementation and leprosy elimination strategies are proposed.
Nsagha
Dickson S
DS
Department of Public Health and Hygiene, Medicine Programme, Faculty of Health Sciences, University of Buea, PO Box 63, Buea, Cameroon. nsaghads@hotmail.com <nsaghads@hotmail.com>
Bamgboye
Elijah A
EA
Oyediran
Alain B O O
AB
D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D005260:Female; D006297:Health Services Accessibility / Q000639:trends*; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage*; D007918:Leprosy / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D007917:Leprostatic Agents