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

Based on WHO data, Indonesia has the third largest leprosy burden in the world, afterIndia and Brazil. Although leprosy was declared to be eliminated in severalprovinces, there are still several leprosy settlements spread in Indonesia. Oneof these settlements is Neglasari village in Tangerang City, West Java, whereleprosy patients have been living since 1981. There is a scarcity ofinformation regarding the features of leprosy in Indonesia, especially aboutthe description of the patients’ posttreatment condition in terms of bothclinical sequelae and health services provided. A collaboration betweenmultiple departments of Ophthalmology, Dermatovenereology, and MedicalRehabilitation from the Cipto Mangunkusumo Hospital/Universitas Indonesia,Jakarta, was established in the form of a health service program to determinethe number and features of disabilities of ex-leprosy patients. We providehealth services, including physical examinations, extend free medication andeye glasses, and impart knowledge about the chronic complications to patientsand local cadres. A nonroutine health service program for leprosy patients wasconducted in Neglasari village, which performed four primary activities ofpromotive, preventive, curative, and rehabilitative. The program included atotal of 260 patients, with a mean age of 50.45 ± 10.15 years and most of thembeing males (60.4%). A duration of >5 years of leprosy was found in 47% ofsubjects, and 96% of them have been released from treatment. Disabilitiescomprised 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 mildimpairment, 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 theextremities revealed that 16% of the subjects had an amputated foot. Spectacleswere successfully distributed to 100% of patients who were visually correctable.This proposed model for leprosy health care program involving multidisciplinaryexpertise is effective for screening numerous disabilities in leprosy patientsat one time. This enables caretakers to determine a holistic management that atthe end is intended to improve the quality of life of patients.