Contact examination in leprosy: a success story

Abstract

Introduction: Leprosy is an infectious disease spread by respiratory droplets. Contact examination of
index cases is recommended for new case detection and as a disease control measure. Public health
authorities are entrusted with contact examination.
Objectives: We report two interventions carried out at the dermatology clinic Base Hospital Homagama
with good results. We planned to analyze the yield of a hospital based contact examination clinic and
to assess the success of public health interventions to find infective cases.
Methods: Intervention 1; All new cases registered in 2016 were requested to bring household contacts
for examination. All contacts who presented were examined for skin lesions. All clinically diagnosed
cases were started on MDT. All suspicious lesions were biopsied. Intervention 2; 5 new cases of single
lesion tuberculoid leprosy, including 3 children, from the same location were detected. Surveys of the
school where the children studied and a house to house survey were carried out.
Results: Intervention 1; There were 110 contacts listed for 32 index cases. Twenty one (21) cases
(65.6%) brought 63 contacts for examination. Eleven (11) contacts for 6 index cases (28.9% index
cases) were positive for leprosy. Intervention 2; The house to house survey revealed a case of
lepromatous leprosy (BI 6+) living next to the first index case. 3 members of his extended family had
single lesion leprosy.
Conclusions: Contact examination clinic is a productive method for early case detection. A well
planned house to house survey would also yield successful results.