Objective: Leprosy post-exposure prophylaxis with single-dose rifampicin (SDR-PEP) has proven effective and feasible, and is recommended by WHO since 2018. This SDR-PEP toolkit was developed through the experience of the leprosy postexposure prophylaxis (LPEP) programme. It has been designed to facilitate and standardise the implementation of contact tracing and SDR-PEP administration in regions and countries that start the intervention. Results: Four tools were developed, incorporating the current evidence for SDR-PEP and the methods and learnings from the LPEP project in eight countries. (1) the SDR-PEP policy/advocacy PowerPoint slide deck which will help to inform policy makers about the evidence, practicalities and resources needed for SDR-PEP, (2) the SDR-PEP field implementation training PowerPoint slide deck to be used to train front line staff to implement contact tracing and PEP with SDR, (3) the SDR-PEP generic field guide which can be used as a basis to create a location specific field protocol for contact tracing and SDR-PEP serving as a reference for frontline field staff. Finally, (4) the SDR-PEP toolkit guide, summarising the different components of the toolkit and providing instructions on its optimal use. Conclusion: In response to interest expressed by countries to implement contact tracing and leprosy PEP with SDR in the light of the WHO recommendation of SDR-PEP, this evidence-based, concrete yet flexible toolkit has been designed to serve national leprosy programme managers and support them with the practical means to Leprosy post-exposure prophylaxis toolkit 357 translate policy into practice. The toolkit is freely accessible on the Infolep homepages and updated as required: https://www.leprosy-information.org/keytopic/leprosy-postexposure-prophylaxis-lpep-programme
Introduction: Non-communicable diseases and elderly population are on the rise worldwide. It has created a massive burden on health systems, economies and society. Sri Lanka is no exception. The situation indicates the need for risk factor prevention and control through effective behaviour change programmes. Self-efficacy is postulated as fundamental to achieve behaviour change of individuals to fill the present gap of risk factor control. Objectives:To assess the perceived self-efficacy in managing chronic diseases to provide an insight into how confident the elderly are in self-managing their diseases Methods: A hospital-based descriptive cross-sectional study was conducted among elderly patients attending the medical clinic at BH Mulleriyawa. By systematic sampling method, 461 eligible patients diagnosed with one or more five major chronic disease categories were selected. An interviewer-administered chronic disease selfefficacy questionnaire validated for Western countries was used to collect data. Mean perceived self-efficacy score was calculated by adding scores of 10 domains. Adjusted odds ratios (AOR) with 95% confidence interval (CI) were calculated to find associations with the control of risk factors. Results:The response rate was 92% (n=424). The study population had a mean perceived self-efficacy score of 3.64 (SD=0.54) out of 5. The existence of multiple co-morbidities among the elderly was significantly associated with perceived self-efficacy (p=0.02). Respondents with a single disease showed 'good' perceived self-efficacy compared to those with two or more co-morbidities. With respect to disease control status, a statistically significant association was found between 'good' perceived self-efficacy and blood pressure control (<140/90 mmHg) (AOR=0.47; 95% CI=0.24, 0.89). However, statistically significant associations were not found between blood sugar control (<110 mg/dl) or total cholesterol level (<240 mg/dl) with 'good' perceived self-efficacy. Conclusions:The elderly patients'overall perceived self-efficacy level was found to be well above the average. Targeted interventions to improve self-efficacy may have a beneficial effect on disease control factors such as blood pressure. Further research studies are needed to longitudinally assess the temporality of perceived selfefficacy and its determinants.
Introduction: Both the curative and preventive sectors of the health system provide services to leprosy patients in Sri Lanka. Identification of the needs and gaps of service delivery would help to redesign the leprosy control activities in the country. Objectives:To assess healthcare service provision to adult leprosy patients in Western Province Methods: A descriptive cross-sectional study was conducted in 12 hospital dermatology clinics and 22 medical officer of health (MOH) offices in the Western Province. The sample was selected through a stratified random sampling method. A pretested checklist was used as the study instrument. Data were gathered by observations, interviewing hospital and MOH office staff.Results: Overall service provision was satisfactory in all selected hospitals. All the hospitals' scores were above 75% indicating an overall satisfactory service provision in all categories of hospitals in the province. However, many deficiencies were identified in the service provision in individual hospitals in selected areas. In 2017, Colombo District had the highest number of leprosy cases (n=157). Case distribution in Western Province showed that Moratuwa (n=88), Negombo (n=31) and Beruwala (n=43) MOH areas had the highest number of cases in the Colombo, Gampaha and Kalutara Districts, respectively. Considering the maintenance of the registers and records of the 22 MOH offices surveyed, most (n=15; 68.2%) of the areas satisfactorily maintained their records. Contact tracing and health education were the main deficiencies identified.Conclusions & Recommendations: Service provision was satisfactory in dermatology clinics. Unsatisfactory record-keeping in some MOH areas was found, while delay in case investigations, poor health education and contact tracing coverage were found in many MOH areas. MOH areas with poor performances should be closely monitored by the supervising officers to ensure the quality of service provision.
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