Enhanced yield of active case finding for leprosy in Uganda, using an integrated ‘Community door to door Awareness raising, Screening, Testing, Treatment and Prevention’ (CAST) campaign in Uganda

Abstract

Summary Background Uganda undertook a six-month national-level campaign to improve access to TB and leprosy services following the negative impacts of COVID-19 on health care services. This paper aims to present the results of a detailed case analysis of all patients with leprosy from 2022 to 2023 and to illustrate the benefit of integrating leprosy active case finding in the tuberculosis awareness, screening, testing, treatment, and prevention (CAST) campaign. Methods The activities implemented during the campaign included community awareness raising and screening and management of suspected TB and Leprosy patients. Data collected at the community level was aggregated at the facility level and entered in an online system. Data analysis from a custom database created for the CAST campaign was conducted. Results Three episodes of the CAST campaign were carried out in March 2022, September 2022, and March 2023. Of the 6,715,810 individuals screened for TB and leprosy, 55% were female. 14,560 were diagnosed with TB. In addition, 4302 individuals had skin lesions suspicious of leprosy, and 5% (196) were diagnosed with leprosy and started on treatment. The overall proportion of leprosy patients contributed by the campaign was 49% (196/399), 60% being from the West Nile region. Conclusions The CAST campaign is an innovative strategy to improve TB and Leprosy control in Uganda. It is crucial to continuously monitor and evaluate the campaign progress, making adjustments as needed to ensure its success. The results also justify the integration of TB and Leprosy programmes particularly in remote settings with high disease burdens. Keywords: Leprosy, CAST campaign, COVID 19, integration