Leprosy persistence in the health district of Kenieba despite its elimination as a public health problem at the national level in Mali
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Abstract
WHO defined leprosy elimination as reaching a prevalence < 1 case of leprosy per 10,000 inhabitants. Mali eliminated the disease since 2001 but in 2011, it recorded 226 new cases. This has a serious involvement in term of disease spreading. Therefore, we undertook a cross sectional study in Kenieba health district, still above the WHO recommended elimination threshold to better understand the disease epidemiology and its associated potential factors. The study took place from October 2013 to September 2014. All consenting villagers, living in one of the selected villages were included and clinically examined for leprosy signs.
A total of 8,457 participants were included in this cross-sectional survey. The median age was 14 varying 0 to 102 years. The sex ratio was equal to 0.92. Nine new leprosy cases corresponding to a new case detection rate of 10.64 per 10,000 population were diagnosed. Four of them were multibacillary leprosy and three were found positive to acid-fast bacilli. The estimated prevalence of leprosy was 24.83 per 10,000 population. Living in Kenieba city (RR = 0.97, CI = [0.95-0.99]), using a bicycle (RR = 0.96, CI = [0.93- 0.99]) or other vehicle as transportation mean to reach the health center (RR = 0.96, CI = [0.93-0.99]) were protective factors significantly associated with new leprosy cases. Other factors such as age, education status, gender, time to reach a health center were not associated with leprosy case. Six among the nine health workers questioned knew at least two clinical signs of leprosy, three, its therapeutic regimens and three claimed to have previously being trained in diagnosing the disease.
Despite leprosy elimination as a public health problem at the country level, it remains highly endemic in the health district of Kenieba.
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Copyright (c) 2020 Coulibaly YI, et al.
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