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Implementation approaches for leprosy prevention with single-dose rifampicin: a support tool for decision making
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 4651873
Author(s) Ter Ellen, F.; Tielens, K.; Fenenga, C.; Mieras, L.; Schoenmakers, A.; Arif, M. A.; Veldhuijzen, N.; Peters, R.; Ignotti, E.; Kasang, C.; Quao, B.; Steinmann, P.; Banstola, N. L.; Oraga, J.; Budiawan, T.
Author(s) at UniBasel Steinmann, Peter
Year 2022
Title Implementation approaches for leprosy prevention with single-dose rifampicin: a support tool for decision making
Journal PLoS Negl Trop Dis
Volume 16
Number 10
Pages / Article-Number e0010792
Mesh terms Humans; Rifampin, therapeutic use; Leprostatic Agents, therapeutic use; Leprosy, microbiology; Mycobacterium leprae; Decision Making
Abstract BACKGROUND: In the past 15 years, the decline in annually detected leprosy patients has stagnated. To reduce the transmission of Mycobacterium leprae, the World Health Organization recommends single-dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients. Various approaches to administer SDR-PEP have been piloted. However, requirements and criteria to select the most suitable approach were missing. The aims of this study were to develop an evidence-informed decision tool to support leprosy programme managers in selecting an SDR-PEP implementation approach, and to assess its user-friendliness among stakeholders without SDR-PEP experience. METHODOLOGY: The development process comprised two phases. First, a draft tool was developed based on a literature review and semi-structured interviews with experts from various countries, organisations and institutes. This led to: an overview of existing SDR-PEP approaches and their characteristics; understanding the requirements and best circumstances for these approaches; and, identification of relevant criteria to select an approach. In the second phase the tool's usability and applicability was assessed, through interviews and a focus group discussion with intended, inexperienced users; leprosy programme managers and non-governmental organization (NGO) staff. PRINCIPAL FINDINGS: Five SDR-PEP implementation approaches were identified. The levels of endemicity and stigma, and the accessibility of an area were identified as most relevant criteria to select an approach. There was an information gap on cost-effectiveness, while successful implementation depends on availability of resources. Five basic requirements, irrespective of the approach, were identified: stakeholder support; availability of medication; compliant health system; trained health staff; and health education. Two added benefits of the tool were identified: its potential value for advocacy and for training. CONCLUSION: An evidence-informed SDR-PEP decision tool to support the selection of implementation approaches for leprosy prevention was developed. While the tool was evaluated by potential users, more research is needed to further improve the tool, especially health-economic studies, to ensure efficient and cost-effective implementation of SDR-PEP.
ISSN/ISBN 1935-2735 (Electronic)1935-2727 (Linking)
Full Text on edoc Available
Digital Object Identifier DOI 10.1371/journal.pntd.0010792
PubMed ID
ISI-Number MEDLINE:36251696
Document type (ISI) Review, Journal Article

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