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Outcome of late healthy household contact examinations in leprosy-affected households in Bangladesh
C. Ruth Butlin
  C. Ruth Butlin
Affiliation
The Leprosy Mission England and Wales, Peterborough, England
Correspondence to: C. Ruth Butlin, 42 Old Drive, Polegate, East Sussex, UK (e-mail: drbutlin@yahoo.com)
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a,*
Peter Nicholls
  Peter Nicholls
Affiliation
The Leprosy Mission England and Wales, Peterborough, England
Independent Statistician
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a,b
Bob Bowers
  Bob Bowers
Affiliation
Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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c
Emily Quilter
  Emily Quilter
Affiliation
London School of Hygiene and Tropical Medicine, London, UK
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d
Md Khorshed Alam
  Md Khorshed Alam
Affiliation
The Leprosy Mission international Bangladesh, Dhaka, Bangladesh
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e
Suren Singh
  Suren Singh
Affiliation
The Leprosy Mission international Bangladesh, Dhaka, Bangladesh
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e
Objective:

Though household contact examinations are a recognised method of active case finding in leprosy control programmes, there is little evidence to determine appropriate duration of annual surveillance, when weighing likely benefit against inconvenience to households and investment in health staff time. Considering this, the aim was to establish the temporal pattern of new case finding through a crosssectional survey, by examining year-wise cohorts of individuals from the households of leprosy cases diagnosed at different times in the past.

 Results:

For multi-bacillary (MB) index cases’ contacts, the new case detection rate (NCDR) falls only after five years from diagnosis of index case. For contacts of paucibacillary (PB) cases, the lower initial NCDR remains well below that for MB index cases.

 Conclusions:

The low rates of new case detection demonstrated in this study would not justify greatly prolonged active surveillance, but household contacts should be warned of their continuing risk.
Keywords
Leprosy Household contacts Routine surveillance New case detection Risk
Cite this article
C. Ruth Butlin, Peter Nicholls, Bob Bowers, Emily Quilter, Md Khorshed Alam, Suren Singh;
Outcome of late healthy household contact examinations in leprosy-affected households in Bangladesh; Leprosy Review; 2019; 90; 3; 305-320; DOI: 10.47276/lr.90.3.305
home.article_information

DOI: 10.47276/lr.90.3.305

articleview.journal_title: Leprosy Review
articleview.publisher: Lepra
articleview.publisher_location: Colchester, UK
articleview.article_date_pre accepted on 29 July 2019 and articleview.pub_on 01 September 2019
© Lepra 2019
LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
30-5320
0305-7518/19/064053+16
10.47276/lr.90.3.305
Original Papers
Outcome of late healthy household contact examinations in leprosy-affected households in Bangladesh
ButlinC. Ruth
a
NichollsPeter
ab
BowersBob
c
QuilterEmily
d
AlamMd Khorshed
e
SinghSuren
e
a
The Leprosy Mission England and Wales, Peterborough, England
b
Independent Statistician
c
Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
d
London School of Hygiene and Tropical Medicine, London, UK
e
The Leprosy Mission international Bangladesh, Dhaka, Bangladesh
Correspondence to: C. Ruth Butlin, 42 Old Drive, Polegate, East Sussex, UK (e-mail: )
01092019
90
3
305
320
29072019
© Lepra
2019
Objective:
Though household contact examinations are a recognised method of active case finding in leprosy control programmes, there is little evidence to determine appropriate duration of annual surveillance, when weighing likely benefit against inconvenience to households and investment in health staff time. Considering this, the aim was to establish the temporal pattern of new case finding through a crosssectional survey, by examining year-wise cohorts of individuals from the households of leprosy cases diagnosed at different times in the past.
Results:
For multi-bacillary (MB) index cases’ contacts, the new case detection rate (NCDR) falls only after five years from diagnosis of index case. For contacts of paucibacillary (PB) cases, the lower initial NCDR remains well below that for MB index cases.
Conclusions:
The low rates of new case detection demonstrated in this study would not justify greatly prolonged active surveillance, but household contacts should be warned of their continuing risk.
LeprosyHousehold contactsRoutine surveillanceNew case detectionRisk