Empowerment of Communities in the Promotion of Prevention of Disability (POD) for Persons Affected by Leprosy in Tanzania

Objective: The 'Prevention of Disability (POD) project for persons affected by leprosy' was designed to strengthen early diagnosis through community empowerment in high endemic districts in Tanzania and to reduce occurrence of leprosy related Grade 2 disabilities. Methods: The project activities were implemented in leprosy high endemic districts with prevalence rates above 1/10,000 population between 2012-2015. 12 districts were involved and 12 new POD Committees with 236 POD members were trained to be trainers. The POD committees trained 100 village health committees with 1,300 members using the POD training manual under the supervision of District Social Welfare Officers [SWOs] and District Tuberculosis and Leprosy Coordinators [DTLCs]. Results: A total of 134,104 people were reached with 65,827 school children from 225 schools and 68,277 adults from 248 villages. Through sensitisation activities involving district POD committees, village health committees, drama groups and community members, 3,483 leprosy suspects were identified and 531 were confirmed by DTLCs as new leprosy cases. Through active case finding activities in household contacts 1399 contacts were reached and 73 new leprosy cases were confirmed. Conclusions: Statistics over the last 14 years showed that there was a decreasing of new leprosy cases notifications during routine passive cases finding period. With start of empowerment of community and household screening activities, the numbers of new cases in the districts increased tremendously. This suggests that there is a high presence of hidden cases. The numbers of new detected cases were in some districts more than doubled by the interventions. The relative low percentage of Grade 2 disability of 9% in the project compared to a current national average of over 12% support the effectiveness of the intervention 'empowerment of communities' for early case detection.