title: Community-based needs assessment of leprosy patients in Chamrajanagar district, Karnataka, India.
abstract: OBJECTIVE
  To assess the medical, disability prevention and rehabilitation and psychosocial needs of leprosy patients.
  
  
  METHODS
  Community-based cross sectional study.
  
  
  RESULTS
  259 registered leprosy-affected people were studied. 26% of subjects had presented by voluntary reporting. The mean detection delay was 8.25 months (SD 6.45). 66.8% of the study subjects had received regular treatment. Knowledge about multi-drug therapy (MDT) was satisfactory in 44.4% whereas knowledge of reactions was highly unsatisfactory. 7.7% had leprosy reactions among which only 25 received medical care. Disability proportion was 20.1% out of which 8.5% had Grade 1 and 11.6% had Grade 2 deformity. All these disabled individuals needed skin care, 44.2% of them needed wound care and 36.5% needed joint care. There was wide discrepancy between need for self care, training received and resources available for practising the same. The extent of dehabilitation was more among subjects with visible deformities.
  
  
  CONCLUSIONS
  Medical needs identified in study subjects include capacity building of patients regarding MDT & reactions, plus awareness generation in general community such that voluntary reporting is enhanced and the detection dela shortened in the district. Strengthening drug inventory and distribution systems fo uninterrupted supply of drugs is essential. There is a need to reorient health care staff regarding leprosy management and DPMR. Rehabilitation needs identified are capacity building with regard to prevention of deformity and supplies (POD tool kit for self care) for the same. It is recommended that the district heath system should conceptualise and implement an evidence-based field level disability care and prevention programme, with community-based rehabilitation approach.
authors: Department of Community Medicine, M S Ramaiah Medical College, Bangalore, India. gauthammsrmc@gmail.com
authors: Melur Sukumar
authors: MS
authors: Gautham
authors: Munivenkatappa
authors: M
authors: Dayananda
authors: Dhruvarao
authors: D
authors: Gopinath
authors: Nallur Somanna
authors: NS
authors: Shivraj
authors: Basha
authors: B
authors: Riyaz
authors: Sreekantaiah
authors: S
authors: Pruthvish
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006301:Health Services Needs and Demand; D006801:Humans; D007194:India; D007918:Leprosy / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010361:Patients / Q000523:psychology; D011788:Quality of Life; D012424:Rural Population; D012944:Social Support; D011795:Surveys and Questionnaires