Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila

Introduction. This paper documents the variations in the diagnosis and management of multibacillary leprosy patients in three of the biggest case-holding hospitals in Metro Manila. Furthermore, we aimed to discuss the implications of these variations on the country’s leprosy control and elimination...

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Main Authors: Pepito, Veincent Christian F, Amit, Arianna Maever L, Samontina, Rae Erica D, Abdon, Sarah Jane A, Fuentes, David Norman L, Saniel, Ofelia P
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Published: Archīum Ateneo 2018
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Online Access:https://archium.ateneo.edu/asmph-pubs/16
https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1015&context=asmph-pubs
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spelling ph-ateneo-arc.asmph-pubs-10152020-07-23T08:49:40Z Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila Pepito, Veincent Christian F Amit, Arianna Maever L Samontina, Rae Erica D Abdon, Sarah Jane A Fuentes, David Norman L Saniel, Ofelia P Introduction. This paper documents the variations in the diagnosis and management of multibacillary leprosy patients in three of the biggest case-holding hospitals in Metro Manila. Furthermore, we aimed to discuss the implications of these variations on the country’s leprosy control and elimination program. Methods. Focus group discussions (FGD) were conducted with 23 health professionals composed of doctors and nurses with at least a year of experience in managing leprosy patients. The topics included procedures on patient diagnosis and management such as treatment duration, patient follow-up and definitions of treatment completion and default. The FGD participants provided suggestions to improve treatment compliance of patients. Their responses were compared with World Health Organization (WHO) standards and/or the 2002 DOH Manual of Operating Procedures (MOP) for leprosy. Transcripts of the recordings of the FGDs were prepared and thematic analysis was then performed. Results. There were variations in the hospitals’ procedures to diagnose leprosy, in treatment duration, and in patient follow-up. Definitions for treatment completion and default differed not just between hospitals but also with the WHO guidelines and the 2002 MOP. Hospitals extended treatment up to 24 or even 36 months, despite the 12 months stipulated in the MOP. Two hospitals required slit skin smear and skin biopsy in diagnosis, despite the MOP and WHO provisions that these were not mandatory. One hospital defined default as three consecutive months without treatment, which was different from the MOP and WHO standards and from the other hospitals. Conclusion. Given the variations in patient management, we recommended that effectiveness of the standard treatment relative to other regimens being practiced by specialists be evaluated. 2018-01-01T08:00:00Z text application/pdf https://archium.ateneo.edu/asmph-pubs/16 https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1015&context=asmph-pubs Ateneo School of Medicine and Public Health Faculty Publications Archīum Ateneo Multibacillary Leprosy Multiple Drug Therapy Patient Management Medicine and Health Sciences Public Health
institution Ateneo De Manila University
building Ateneo De Manila University Library
continent Asia
country Philippines
Philippines
content_provider Ateneo De Manila University Library
collection archium.Ateneo Institutional Repository
topic Multibacillary Leprosy
Multiple Drug Therapy
Patient Management
Medicine and Health Sciences
Public Health
spellingShingle Multibacillary Leprosy
Multiple Drug Therapy
Patient Management
Medicine and Health Sciences
Public Health
Pepito, Veincent Christian F
Amit, Arianna Maever L
Samontina, Rae Erica D
Abdon, Sarah Jane A
Fuentes, David Norman L
Saniel, Ofelia P
Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila
description Introduction. This paper documents the variations in the diagnosis and management of multibacillary leprosy patients in three of the biggest case-holding hospitals in Metro Manila. Furthermore, we aimed to discuss the implications of these variations on the country’s leprosy control and elimination program. Methods. Focus group discussions (FGD) were conducted with 23 health professionals composed of doctors and nurses with at least a year of experience in managing leprosy patients. The topics included procedures on patient diagnosis and management such as treatment duration, patient follow-up and definitions of treatment completion and default. The FGD participants provided suggestions to improve treatment compliance of patients. Their responses were compared with World Health Organization (WHO) standards and/or the 2002 DOH Manual of Operating Procedures (MOP) for leprosy. Transcripts of the recordings of the FGDs were prepared and thematic analysis was then performed. Results. There were variations in the hospitals’ procedures to diagnose leprosy, in treatment duration, and in patient follow-up. Definitions for treatment completion and default differed not just between hospitals but also with the WHO guidelines and the 2002 MOP. Hospitals extended treatment up to 24 or even 36 months, despite the 12 months stipulated in the MOP. Two hospitals required slit skin smear and skin biopsy in diagnosis, despite the MOP and WHO provisions that these were not mandatory. One hospital defined default as three consecutive months without treatment, which was different from the MOP and WHO standards and from the other hospitals. Conclusion. Given the variations in patient management, we recommended that effectiveness of the standard treatment relative to other regimens being practiced by specialists be evaluated.
format text
author Pepito, Veincent Christian F
Amit, Arianna Maever L
Samontina, Rae Erica D
Abdon, Sarah Jane A
Fuentes, David Norman L
Saniel, Ofelia P
author_facet Pepito, Veincent Christian F
Amit, Arianna Maever L
Samontina, Rae Erica D
Abdon, Sarah Jane A
Fuentes, David Norman L
Saniel, Ofelia P
author_sort Pepito, Veincent Christian F
title Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila
title_short Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila
title_full Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila
title_fullStr Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila
title_full_unstemmed Variations in the Clinical Managementof Multibacillary Leprosy Patientsin Selected Hospitals in Metro Manila
title_sort variations in the clinical managementof multibacillary leprosy patientsin selected hospitals in metro manila
publisher Archīum Ateneo
publishDate 2018
url https://archium.ateneo.edu/asmph-pubs/16
https://archium.ateneo.edu/cgi/viewcontent.cgi?article=1015&context=asmph-pubs
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