Prevention Of Leprosy Research Articles

Hubungan Faktor Risiko dengan Kejadian Penyakit Kusta di Kota Kupang Tahun 2018

Leprosy is a disease caused by The mycobacterium leprae which has a 2-5 year incubation period that attack The skin, peripheral nerves, upper respirator mucosa and eyes. The number of leprosy cases in Kupang experienced fluctuatuions where Three were 63 cases in 2013, 61 cases in 2014, 74 cases in 2015 and 66 cases in 2016. The purpose of this Study has to analyze the riskf ractors associated with the incidence of leprosy in Kupang in 2018. The type of research used was an analytical survei using the Case Control desing. The Population in this Study were 66 people, with a Case sampel of 23 people and a Control sampel of 46 people, a total sampel of 69 people. The sampling technique used was simpel random sampling. The statistical test used was the Chi Square Test. The Results of the analysis showed that room temperatur factors had a significal relationship with the incidence leprosy with a P value of 0.002 (P<0,05) while knowledge, personal hygiene, length of contact, humidity, occupancy density did not have signifikan relationship with the incidence of leprosy. Suggestions for health institutions is that the should provide more comprehensive and sustainable education to the community in order to increase the knowledge about leprosy and the community should participate in conseling about leprosy and be able to participate in the prevention of leprosy.

Community knowledge, attitude, and perceived stigma of leprosy amongst community members living in Dhanusha and Parsa districts of Southern Central Nepal.

BackgroundThough Nepal declared leprosy elimination in 2010, its burden is constantly rising in Terai communities for the past 2 years with 3000 new leprosy cases being diagnosed annually. Community’s perception is important for prevention and control of leprosy and enhancing quality of life of leprosy patients. Poor knowledge, unfavorable attitude and stigma create a hindrance to leprosy control. The main objective of this study was to assess the knowledge, attitude and stigma of leprosy amongst the community members living in Dhanusha and Parsa districts of Southern Central Nepal.MethodsA total of 423 individuals were interviewed using a structured questionnaire in Dhanusha and Parsa districts. Data was analyzed using both descriptive (frequency, percentage, median) and statistical inferences (Chi-square test, Kruskal Wallis H test, Mann Whitney U test, binary logistic regression) using SPSSvs20.ResultsAll respondents had heard about leprosy. Source of information on leprosy was mainly found to be health workers/hospitals (33.1%). Only 62.6% reported bacteria being its cause followed by other myths such as bad blood/curse/heredity/bad deeds (36%). Only 43.8% responded that leprosy is transmitted by prolonged close contact with leprosy patients and 25.7% reported religious rituals as the treatment. Only 42.1% had good knowledge and 40.9% had favorable attitude. Good knowledge of leprosy was highly associated with favorable attitude towards leprosy (P<0.001). The outcome variables- knowledge, attitude and EMIC score were found to have highly significant association with age, sex, ethnicity, religion, education and occupation of the respondents (P<0.001). Having knowledge on leprosy transmission was positively associated with favorable attitude towards leprosy (P<0.001).ConclusionsStrategizing the awareness programmes according to socio-demographic characteristics for enhancing the knowledge regarding leprosy cause, symptoms, transmission, prevention and treatment, can foster the positive community attitude towards leprosy affected persons. Enhancing positive attitude towards leprosy affected persons can reduce the community stigma, thus may increase their participation in the community. Positive attitude may further increase their early health seeking behaviour including their quality of life.

Effect of Psychoeducation-Modification on the Improvement of Spiritual Response, Perception Stigma, Anxiety Level and Cortisol Levels among Lepers

Objective: This study aims analyze the effect of psychoeducation-modification (MP) intervention on the improvement of spiritual response, perception stigma, anxiety level, and cortisol levels among lepers. Method and Materials: This study was a mixed method design. The first stage used qualitative method to develop a psychoeducation-modification module and the second stage was a quantitative method with quasi-experiment using pre-test post-test with control group design. The population was patients who received MDT (Multi Drugs Therapy) treatment, with a total sample of 35 respondents. Statistical tests used the T test, ANOVA test, and pathway analysis. Interventions for psychoeducation-modification were provided in 5 sessions and each session 60-90 minutes Results: There were significant differences in mean scores of spiritual response, perception stigma and anxiety levels scores between intervention group and control group (p-value 0.05). The psychoeducation modification effect was more targeted at improving emotional and spiritual intelligence which had an impact on the improvement of spiritual response, Perception Stigma, anxiety level and stability in cortisol levels decrease. Conclusion: Psychoeducation-modification was effective in improving spiritual response, perception stigma, anxiety level, and cortisol levels among lepers compared to intervention using psychoeducation only. It is recommended to integrate psychoeducation modification intervention into the leprosy prevention service program as a holistic service that includes spiritual bio-psycho-social aspects. © 2019, Indian Journal of Public Health Research and Development. All rights reserved.

Correlation Of Knowledge About Prevention Of Kusta Disease and Kusta Transmission Risk In Primary Health Care Losari , Kedaton And Babakan,Cirebon District

Background:Knowledge of leprosy prevention is the knowledge of a person doing a first line prevention or pervention action before a disease occurs. Based on data from Cirebon district Health OfficeThe incident of leprosy are 232 patients.According to the data primary health center Losari, Kedaton and Babakan There are 37 leprosy patients.&#x0D; Purpose: This research aimed to know an overview of knowledge about the prevention of leprosy, know an overview risk of cutaneous transmission, and knowlegde connection of prevention with leprosy transmission of primary health center Lossari, Kedaton and Babakan Cirebon District.&#x0D; Method:This is quantitative with Cross Sectional Study design. The population in this research is family members of leprosy primary health center Losari, Kedaton dan Babakan Cirebon district. The samples were choosen by Propotional Random Sampling which amounted to 114 respondents. The data retrieval research was conducted on 15 July – 15 September 2018. The research instrument was a questionnaire. Data analysis using Chi Square test.&#x0D; Result:The result of univariate analysis shows that connection of prevention leprosy was motsly good, that is mostly less 14 respondent (46,7%) and leprosy transmission mostly not risk 21 respondent (70,0%),. The result of chi square test was obtained p value = 0,011.&#x0D; Conclusion:Its indicatedthat there is a relationship betweenIndicating that H0 is rejected an Ha accepted means the a knowlegde connection of prevention with leprosy transmission of primary health center Lossari, Kedaton and Babakan Cirebon District

MEDIA LEAFLET MENCEGAH LEPRA DI DESA KAYULOMA KECAMATAN BASIDONDO KABUPATEN TOLI-TOLI

ABSTRACT Leprosy is one of the infectious diseases caused by Mycobakterium leprae. Lack of knowledge, attitudes and actions against leprosy, making this disease feared by the public. This study aims to knowing the effect of education method with leaflet media on knowledge, attitude and actions on behavior of leprosy patients to prevention of leprosy in the Kayulompah Village Basidondo District of Tolitoli Regency. This study used quasi eksperimen technique with non-randomized pre dan posttest only control design. The study sample are the 40 leprosy patients with purposive sampling technique. The independent variables are educational methods of lectures with media leaflets about leprosy and it’s prevention, while the dependent variable is knowledge, attitude and action of respondent. The technique of data analysis used paired sample t-test. The result of the study show that there are influence of educational intervention using lecture method with media leaflet on knowledge, attitude and actions on behavior of leprosy patients to prevention of leprosy in the Kayulompah Village Basidondo District of Tolitoli Regency 2017. It is proved by the p-value of pretest and posttest in each variable is significantly smaller than 0.05 (5%) is knowledge 0,000; attitude is 0,000 and actions is 0,000. The average value of knowledge, attitudes and actions of respondents who experienced an increase each week, show that intervention using lecture method with media leaflet give a positive impact of change on knowledge, attitudes and actions of leprosy patients and prevention.Keywords : leprosy, health education, leaflet media

Population-wide administration of single dose rifampicin for leprosy prevention in isolated communities: a three year follow-up feasibility study in Indonesia

BackgroundIndonesia ranking third in the world, regarding leprosy burden. Chemoprophylaxis is effective in reducing risk of developing leprosy among contacts. ‘Blanket approach’ is an operational strategy for leprosy post-exposure prophylaxis in which all members of an isolated community, high endemic for leprosy are screened and given a single dose of rifampicin (SDR) in the absence of signs and symptoms of leprosy. The objective is to assess the operational feasibility of a population-wide ‘blanket’ administration of SDR for leprosy prevention in isolated communities in a remote island.MethodsA prospective follow-up study was conducted in the year 2014, 2015 and 2016 in Lingat village of Selaru Island, Indonesia. During the first two visits, screening and SDR were provided, whereas only screening was conducted during the third visit. The demographic and clinical data were used for a descriptive analysis of the project coverage and leprosy epidemiology.ResultsDuring the first two visits, 1671 persons (88%) were screened, 1499 (79%) received SDR, and 213 (11%) were excluded based on the exclusion criteria. During the first two visits, 43 (2.6%) cases were diagnosed with leprosy with a rate of 2263 per 100,000 population. The prevalence was highest in the age groups 15–24 and 25–49 years. Total, 14 (33%) cases had MB and 29 (67%) PB leprosy. Two cases (5%) had grade 2 disability. During the third visit, 10 new leprosy cases, with no grade 2 disability, were detected out of 1481 screened persons at the rate of 484 cases per 100,000 population (n = 2065 population in 2016). Among those screened during the third visit, there was a 50% reduction of leprosy among those who had previously received SDR compared to those who had not.ConclusionWith adequate planning and some additional investment, it is feasible to implement a blanket approach of chemoprophylaxis in a remote island of Indonesia, although effort needs to be made to cover as many people as possible in the first visit. Contingency plans need to be made to actively follow this village closely in the coming years and continue leprosy elimination efforts until no new cases are found any more.

Active case-finding and enhanced data collection to identify neglected tropical diseases

ObjectiveTo strengthen public health surveillance to monitor neglected tropical diseases (NTDs) like leprosy as a control measure to avert disabilities in the Kingdom of Swaziland.IntroductionLeprosy is a chronic infectious disease caused by Mycobacterium leprae. It is a contagious disease that affects the skin, mucous membrane, and nerves causing discoloration and lumps on the skin and in severe cases disfigurement and deformities. The mode of transmission remains uncertain, but is believed that M.leprae is spread from person to person primarily as a nasal droplet infection. The incubation period for a bacterial disease generally is 5 – 7 years. Progress in the fight against leprosy has been one of the greatest public health success and in the country, was eliminated in the mid-1990s. However on the 22nd August 2017 a confirmed leprosy cases was reported by the National Referral Hospital.MethodsFollowing the confirmed case an investigation was conducted to fully understand the possible source of the case and identify further cases. The assessment was done in three parts that is, hospital visit to follow up on the index case; conducting home visits to collect data for leprosy and their contact and a file review of all clients who were once diagnosed as having leprosy.ResultsThe index case was identified and his condition is improving as he has been initiated on MDT which he will be taking for a minimum of six months. Eleven clients were visited in their homes. Their age range was 31 to 91 years but the majority were above 60 years with a median age of 70 years. There were 7 females and 4 males. . The clients presented with permanent nerve damage either from the face, upper or lower limbs. The common disabilities and deformities post treatment were sagging of face, nasal collapse, blindness and clawing of fingers and feet. Other patients had plantar-palmar ulcers and abscesses from trauma, injuries or burns sustained due to nerve damage and inadequate protection. They reported to be experiencing stigma and are being discriminated. None of the clients presented with clinical signs and symptoms suggestive of leprosy. There were 18 files that were reviewed out of 58 who are known to exist. Six of the 18 files belonged to clients who were seen during home visits. One of the clients was epidemiologically linked to the index case as they used to live together in 1994.ConclusionsThe country seem to be experiencing the re-emerging of leprosy. Since the index case is epidemiologically linked to one of the old cases this therefore confirms the incubation period of leprosy being from 15 to 20 years. There is need to strengthen leprosy prevention and control measures as well as strengthening of leprosy surveillance in the context of IDSR. There is an urgent need to raise public awareness and provide clients with protective clothing. Furthermore, there is need to strengthen the Bilharzia and Worms Control Program to incorporate leprosy as it is one of the NTDs targeted for elimination in Swaziland.

ASSESSMENT OF KNOWLEDGE AND AWARENESS ABOUT LEPROSY AMONG MEDICAL COLLEGE STUDENTS IN MEWAT REGION OF HARYANA

Introduction -Leprosy is a chronic infectious disease which still remains a serious public health problem due to its ability to cause disability. The prevention of leprosy ultimately lies in the early diagnosis and treatment of the individuals having leprosy. Changing leprosy scenario has led to requirement of leprosy education. However the knowledge of medical college students on leprosy remains unknown. Aim: To assess the post-sensitization knowledge and awareness of medical students after state leprosy sensitization program. Materials and methods: A questionnaire based, cross sectional study was conducted among 107 medical students of different years starting from 2nd year and onwards in the month of July 2017 after state leprosy sensitization program. Results: Among the medical students 70 (75%) were male students and 37(25%) were female students coming from different years of their admission in medical college .Regarding the basic knowledge of leprosy 100 % of 3nd year and final year students were having knowledge about the cause of leprosy and 100% of final year and 3rd year medical students know about other name of Leprosy (Hansen,s disease) respectively.100% of final year, 3rd year and 2nd year medical students had knowledge about multidrug therapy (MDT) in in-depth knowledge of leprosy respectively. Regarding the virulence of bacilli 87%, 60% and 63% of final, 3rd and 2nd year medical students had apt knowledge respectively. Conclusion-These observations suggest that the basic and in-depth knowledge of medical students about cause, types, prevention and treatment etc. of leprosy shows increasing trend owing to the part of their curriculum. However there is still a need to organize sensitization programs at regular intervals to impart basic and in-depth knowledge to new medical students, as well as to update the knowledge of those who already had such sensitization programs.Keywords: Awareness; Knowledge; Leprosy; Sensitization.

A Long Way to Kyosei (Living Together) Society: The Trajectory of the Hansen’s Disease Recoverees’ Movement to Repeal the “Leprosy Prevention Law”

A Long Way to Kyosei (Living Together) Society: The Trajectory of the Hansen’s Disease Recoverees’ Movement to Repeal the “Leprosy Prevention Law”

Leprosy in Children.

This manuscript aims to review the cutting-edge developments regarding to the diagnosis, management, and prevention of leprosy in children. Leprosy transmission still occurs continuously in some endemic areas in the world. Leprosy in children below 15years old is a robust indicator of active source of infection in the community where they live. A special focus on children to reduce disabilities and reduce transmission is one of the core areas of interventions of the global leprosy strategy 2016-2020. Ongoing research is trying to develop better diagnostic tests and to advance chemoprophylaxis and immunoprophylaxis approaches. Early diagnosis in children can be hard because of the wide range of clinical aspects of the skin lesions and mainly due to the difficulty of performing the clinical peripheral nerve evaluation. We must maintain leprosy expertise and improve the health professionals training for leprosy diagnosis, since we still have a long journey to reach leprosy elimination.

Knowledge, Attitudes and Practices relating to Leprosy among Public Health Care Providers in Colombo, Sri Lanka

Leprosy remains a serious public health problem due to its ability to cause disability. The prevention of leprosy ultimately lies in the early diagnosis and treatment of the individuals having leprosy, thereby preventing further transmission. In Sri Lanka, 46% of new cases identified in year 2013, were late presentations and this caused to 7-8% patients to present with deformities. It has been observed that lack of awareness among health staff has contributed to this late diagnosis. To describe knowledge, attitudes and practices towards leprosy amongst public health care workers in Colombo Municipal Council area, Sri Lanka. A descriptive cross sectional survey was carried out in Colombo Municipal Council area by distributing self administered questionnaire among all public healthcare workers (n=178) from January to February, 2015. Hundred and fifty three participants (86%) identified ‘hypo pigmented patches’, 64 (36%) identified ‘skin nodules’ and 36 (20%) identified ‘thickened nerves’ as suspicious sings of leprosy. More than one fifth of participants believed leprosy is easily transmitted by touch. Sixty one (34.3%) health care workers were scared of leprosy and 77 (43.3%) didn’t want to reveal to a friend that if a family member gets leprosy. Another 49 (27.5%) didn’t want to share materials with a patient. A significant minority (22.5%) believed that patients should be kept apart from others. Including leprosy in continuous medical education and refresher training is crucial in early diagnosis of leprosy as certain gap in knowledge was identified. An emphasis needs to be placed on education regarding transmission and low rate of infectivity of leprosy as study revealed certain misconceptions and prejudices still exist even among healthcare workers.

Educando para o diagnóstico precoce da hanseníase no município de Rondonópolis - Mato Grosso

http://dx.doi.org/10.5007/1807-0221.2016v13n23p45Rondonópolis-MT vem apresentando altos índices de casos de hanseníase, levando a necessidade de ações educativas preventivas. O projeto de extensão “Hanseníase: diagnóstico precoce é a solução” é realizado com parceria da Secretaria de Saúde há 4 anos com o Curso de Enfermagem UFMT/ICEN/CUR. Objetivou realizar atividades de orientação sobre prevenção da hanseníase nas áreas das unidades de saúde, educação em serviço, palestras em escolas e participação em mutirões, entre março de 2014 a março de 2015. O público-alvo foram 1764 moradores, além dos alunos e profissionais das escolas e equipes de saúde. Foram encaminhados 22 casos suspeitos, sendo confirmados 11 novos, formação de profissionais e nas escolas. Nesta ação de cidadania, o projeto contribuiu significativamente com o diagnóstico precoce da hanseníase e com a saúde pública do município. Sugere-se que novos projetos sejam realizados para favorecer a qualidade da atenção básica, estimulando a participação da academia através da extensão universitária.

Knowledge and Attitude about Leprosy among Indian Dental Students in Faridabad.

Role of dentists in prevention and sustainable care of leprosy is known. Changing leprosy scenario has led to requirement of change in leprosy education. However, knowledge and attitude of dental students on leprosy remains unknown. Hence a study was conducted to assess knowledge and attitude of dental students about Leprosy. A questionnaire based, cross-sectional survey was conducted among 350 undergraduate and the postgraduate dental students of two dental colleges in Faridabad, India. The score for knowledge ranged from 0 to 16 and scores for attitude ranged from 0 to 26. These scores were further coded as poor, fair and good. Mean knowledge score for the sample was 7.64±3.23. A total of 32.29% participants were under poor knowledge category; 57.42% had fair knowledge about Leprosy while 10.29% had good knowledge. Mean attitude score was 15.5 ± 5.98. A total of 30.57% had poor attitude scores, 42.57% had fair scores while 26.86% had good attitude scores. Univariate analysis showed year of training to be a significant predictor for knowledge level (t=7.12; p<0.001). The results indicate need for three important changes towards Leprosy in Dentistry. These changes are need for incorporation of leprosy education in Dentistry, need for incorporation of problem based as well as evidence based learning in Dentistry integrated with general health and need for reestablishing public health programs for Leprosy utilizing dental workforce.

Genetics of leprosy: Expected—and unexpected—developments and perspectives

A solid body of evidence produced over decades of intense research supports the hypothesis that leprosy phenotypes are largely dependent on the genetic characteristics of the host. The early evidence of a major gene effect controlling susceptibility to leprosy came from studies of familial aggregation, twins, and complex segregation analysis. Later, linkage and association analysis, first applied to the investigation of candidate genes and chromosomal regions and more recently, to genome-wide scans, have revealed several HLA and non-HLA gene variants as risk factors for leprosy phenotypes such as disease per se, its clinical forms, and leprosy reactions. In addition, powerful, hypothesis-free strategies such as genome-wide association studies have led to an exciting, unexpected development: Leprosy susceptibility genes seem to be shared with Crohn’s and Parkinson’s disease. Today, a major challenge is to find the exact variants causing the biological effect underlying the genetic associations. New technologies, such as Next Generation Sequencing—that allows, for the first time, the cost- and time-effective sequencing of a complete human genome—hold the promise to reveal such variants; thus, strategies can be developed to study the functional impact of these variants in the context of infection, hopefully leading to the development of new targets for leprosy treatment and prevention.

Recent Review of Literature on Early Diagnosis and Prevention of Leprosy

Recent Review of Literature on Early Diagnosis and Prevention of Leprosy

Clinical manifestations of leprosy after BCG vaccination: An observational study in Bangladesh

BackgroundAlthough BCG is used as a vaccine against tuberculosis, it also protects against leprosy. Previous evaluation over 18 years of an intervention of two doses BCG for 3536 household contacts of leprosy patients showed that 28 (23%) out of 122 contacts diagnosed with leprosy, developed symptoms 2–10 months after vaccination. This study describes contacts of leprosy patients in Bangladesh who developed leprosy within 12 weeks after receiving a single BCG dose. MethodsA cluster RCT in Bangladesh aims to study the effectiveness of the BCG vaccine versus BCG in combination with single dose rifampicin (SDR) given 2 to 3 months after BCG, in the prevention of leprosy among contacts of newly diagnosed leprosy patients. During the first 1,5 years of this ongoing trial we identified contacts who developed leprosy within the first 12 weeks after receiving BCG vaccination, the timeframe before SDR is given. ResultsWe identified 21 contacts who developed leprosy within 12 weeks after BCG vaccination among 5196 vaccinated contacts (0.40%). All 21 cases presented with paucibacillary (PB) leprosy, including children and adults. About half of these cases had previously received BCG vaccination as indicated by the presence of a BCG scar; 43% presented with signs of nerve function impairment and/or Type 1 (reversal) reaction, and 56% of the index patients had multibacillary (MB) leprosy. ConclusionAn unexpectedly high proportion of healthy contacts of leprosy patients presented with PB leprosy within 12 weeks after receiving BCG vaccination, possibly as a result of boosted cell-mediated immunity by homologues of Mycobacterium leprae antigens in BCG. Various immunological mechanisms could underlie this phenomenon, including an immune reconstitution inflammatory syndrome (IRIS). Further studies are required to determine whether BCG vaccination merely altered the incubation period or actually changed the course of the infection from self-limiting, subclinical infection to manifest disease.

Analytical research on Zheng Hao's Participation of the International Congress of Leprosy in 1909

The Second International Congress was held in August, 1909 in Norway. Zheng Hao was dispatched by the Qing Government to attend the Congress as a representative. Through the Congress, Chinese people got to understand the latest ideas of prevention and treatment of leprosy in international medical field, and the approaches they adopted as well at that time. Meanwhile, Zheng Hao frankly confessed the backward status on the prevention and treatment in leprosy in China, and expressed the strong will to learn from the western world in this regard. This historical event, commonly ignored, manifested the fact that, beginning from the late Qing Dynasty, the involvement of Chinese medicine into the world medical trend as a whole was proceeding. By seizing this rare chance of participating the international meeting, the outstanding Chinese medical persons, with Zheng Hao as its representative, made up their mind to keep up with the international medical advanced pace, learning lessons, and pushing forward the development of Chinese medicine.

Genetics of leprosy: Expected and unexpected developments and perspectives

A solid body of evidence produced over decades of intense research supports the hypothesis that leprosy phenotypes are largely dependent on the genetic characteristics of the host. The early evidence of a major gene effect controlling susceptibility to leprosy came from studies of familial aggregation, twins, and Complex Segregation Analysis. Later, linkage and association analysis, first applied to the investigation of candidate genes and chromosomal regions and more recently, to genome-wide scans, have revealed several leukocyte antigen complex and nonleukocyte antigen complex gene variants as risk factors for leprosy phenotypes such as disease per se, its clinical forms and leprosy reactions. In addition, powerful, hypothesis-free strategies such as Genome-Wide Association Studies have led to an exciting, unexpected development: Leprosy susceptibility genes seem to be shared with Crohn’s and Parkinson’s diseases. Today, a major challenge is to find the exact variants causing the biological effect underlying the genetic associations. New technologies, such as Next Generation Sequencing that allows, for the first time, the cost and time-effective sequencing of a complete human genome, hold the promise to reveal such variants. Strategies can be developed to study the functional effect of these variants in the context of infection, hopefully leading to the development of new targets for leprosy treatment and prevention.

RESEARCH ON THE KNOWLEDGE AND PRACTICE OF HEALTH EDUCATION OF COMMUNES AND WARDS MEDICAL OFFICERS IN THUA THIEN HUE PROVINCE IN 2011

Objectives: To evaluate level of the knowledge and practice on health education of communes and wards medical officers of Thua Thien Hue province. Sample size: included 888 medical officers of the 152 communes and wards health centers of Thua Thien Province. Methodology: Cross-sectional description. Results: There was no medical officer get a good knowledge level; fair level was 20.4%, average level was 53.9% and poor level was 25.7%. Mean score of health education knowledge of some health care programes was lower than the total of score: Mental Health was the lowest (2.78/23 score); reproductive health care was 4.14/29 score; cancer prevention was 4.43/26.5 score, malaria prevention was 4.79/16.5 score. Tuberculosis control was 5.17/5.5 score; EPI was 5.57/27 score; Leprosy prevention was 5.96/11.5 score, HIV / AIDS was 5.96/15 score; the prevention of malnutrition was 6.21/27 score. The good level of face to face health education practice was 14.3%, fair level was 24.0%; average level was 42.7%, and poor level was 19.0%. Conclusion: The low percentage of communes and wards medical oficers had good and fair level of health education knowledge and practice. It is necessary to define causes and develope solutions to improve health education efficiency. Key words: Knowledge, practice, health education.

The Prevention of Leprosy Related Disability as an Integral Component of the Government Health Delivery Programme in Indonesia: Perspectives on Implementation

This paper presents a record of three interviews with groups of Ministry of Health personnel and consultants that took place in Jakarta, Indonesia in May 2012. Those contributing to the first interview were provincial and district supervisors with responsibility for leprosy. Those contributing to the second interview were consultants, three of whom were seconded to the Ministry of Health and one was a WHO consultant. A third interview was conducted with the Head and a technical staff member of the Sub Directorate of Leprosy and Yaws Control Programme, Ministry of Health, Indonesia. Leprosy control in Indonesia had been targeted for further enquiry after it became apparent, through an earlier survey of national programme managers and consultants, that the programme had been relatively successful in integrating POD into the government health delivery programme. The perspectives of significant representatives and actors in the national programme were recorded through the interviews undertaken in Jakarta. Limitations This report does not purport to be a study of integration of leprosy services in Indonesia. The perspectives of representatives and significant actors are offered here to enhance understanding of factors that contributed to POD becoming a routine component of general health care in Indonesia. It is also declared here that no independent verification of statements was undertaken and that the effectiveness of measures taken to integrate leprosy related POD has not been independently evaluated.