Health care service for leprosy patients in Sitanala Tangerang (A proposed approach of comprehensive health care for Leprosy patient)

Abstract

Based on WHO data, Indonesia has the third largest leprosy burden in the world, after India and Brazil. Although leprosy was declared to be eliminated in several provinces, there are still several leprosy settlements spread in Indonesia. One of these settlements is Neglasari village in Tangerang City, West Java, where leprosy patients have been living since 1981. There is a scarcity of information regarding the features of leprosy in Indonesia, especially about the description of the patients’ posttreatment condition in terms of both clinical sequelae and health services provided. A collaboration between multiple departments of Ophthalmology, Dermatovenereology, and Medical Rehabilitation from the Cipto Mangunkusumo Hospital/Universitas Indonesia, Jakarta, was established in the form of a health service program to determine the number and features of disabilities of ex-leprosy patients. We provide health services, including physical examinations, extend free medication and eye glasses, and impart knowledge about the chronic complications to patients and local cadres. A nonroutine health service program for leprosy patients was conducted in Neglasari village, which performed four primary activities of promotive, preventive, curative, and rehabilitative. The program included a total of 260 patients, with a mean age of 50.45 ± 10.15 years and most of them being males (60.4%). A duration of >5 years of leprosy was found in 47% of subjects, and 96% of them have been released from treatment. Disabilities comprised 52.5% in the eye, 87.7% in the hand, and 92% in the foot. In total, 65% of the patients had an uncorrected visual acuity of normal to mild impairment, whereas 5.8% were blind. Eye abnormalities included madarosis (43.9%), entropion (41%), cataract (26%), corneal hypoesthesia (20.6%), trichiasis (17.8%), and lagophthalmos (15.1%), and examination of the extremities revealed that 16% of the subjects had an amputated foot. Spectacles were successfully distributed to 100% of patients who were visually correctable. This proposed model for leprosy health care program involving multidisciplinary expertise is effective for screening numerous disabilities in leprosy patients at one time. This enables caretakers to determine a holistic management that at the end is intended to improve the quality of life of patients.