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Progress towards a leprosy-free country: the experience of Oman
PLOS Neglected Tropical Diseases ( IF 3.8 ) Pub Date : 2017-11-20 , DOI: 10.1371/journal.pntd.0006028
Salah T. Al Awaidy

Introduction

The World Health Organization (WHO) released the Global Leprosy Strategy 2016–2020 towards a leprosy-free world. The author described the progress made towards the elimination of leprosy and suggested recommendations for the acceleration towards a Leprosy-free country according to WHO laid out criterion.

Methodology

Case record review of Leprosy patients managed between the years 1992 to 2015 were registered and analyzed. Data were collected from annual reports of the Ministry of Health including demographics, classification of leprosy new cases, relapse, childhood, grades of disability (GD) and multidrug therapy (MDT) completion rates.

Results

Leprosy prevalence rate declined from 1.64 to 0.09 per 10,000 population during the period 1992 and 2015 (p<0.0001). Between 2005 and 2015, 77 patients were diagnosed with Leprosy as per definition and 75/77 (98%) had smear or biopsy positive. Of these, 53 (69%) cases were among foreign-born (non-national) (p<0.003) and 19 (25%) were among women. Most of the leprosy cases were notified in Muscat governorate 29 (38%) and among patients between 25–44 years of age 41 (53%), followed by ≥45 years 29 (38%) and 6 (8%) were children age ≤ 14 years. Multi-bacillary (MB) cases reported 60 versus 17 for Pauci-bacillary (PB) (p< 0.01), while MB was highest among both nationals (83%) and foreign-born (75%).

MDT completion rate was 100% and no relapse cases were notified among nationals. The rate of new patients diagnosed with leprosy related disability was 2.3 per million population, and grade 2 disability (G2D) rate among nationals was 0.9 per million population. No disability was recorded among women or children less than 14 years within the nationals group from 2013. Almost all the foreign-born patients didn’t complete their treatment in Oman as they left the country shortly after diagnosis of leprosy due to a very short term contract, discretionary employment practices by the employers and prefer to go home to complete their treatment.

Conclusion

Oman has met the elimination goals and made great strides towards becoming a leprosy-free country. However, challenges such as improving surveillance system efficiency and sensitivity for detecting timely leprosy cases, as well as foreign-born workers are still a major concerns.



中文翻译:

向无麻风病国家迈进:阿曼的经验

介绍

世界卫生组织(世卫组织)发布了《 2016-2020年全球麻风战略》,旨在建立一个无麻风的世界。作者描述了在消除麻风病方面取得的进展,并提出了根据世卫组织制定的标准加快向无麻风病国家发展的建议。

方法

登记并分析了1992年至2015年间治疗的麻风病人的病例记录。数据来自卫生部的年度报告,包括人口统计资料,麻风病新病例分类,复发,儿童期,残疾等级(GD)和多药治疗(MDT)完成率。

结果

在1992年至2015年期间,麻风患病率从每10,000人口1.64下降至0.09(p <0.0001)。在2005年至2015年之间,按照定义,有77名患者被诊断出患有麻风病,其中75/77(98%)的涂片或活检阳性。其中,53例(69%)是外国出生的(非本国)病例(p <0.003),19例(25%)是女性。大部分麻风病例在马斯喀特省29(38%)和25-44岁41岁(53%)的患者中被告知,随后≥45岁的29岁(38%)和6(8%)为儿童年龄≤14年。多细菌性(MB)病例报告为60例,而鲍氏杆菌(PB)则为17例(p <0.01),而本国人(83%)和外国出生者(75%)的MB最高。

MDT完成率为100%,并且没有国民之间的复发病例通知。被诊断患有麻风病相关残疾的新患者比​​率为每百万人口2.3,而国民中的2级残疾(G2D)比率为每百万人口0.9。自2013年以来,在国民组中没有记录不到14岁以下妇女或儿童中的残疾。几乎所有外国出生的患者在麻风病诊断后不久就因短期离开该国而未在阿曼完成治疗合同,由雇主酌情雇用,并喜欢回家完成治疗。

结论

阿曼已经实现了消灭目标,并朝着成为无麻风病国家迈出了巨大的步伐。但是,诸如提高监视系统的效率和及时发现麻风病的敏感性以及外国出生的工人等挑战仍然是主要关注的问题。

更新日期:2017-11-21
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