Myths, misconceptions and attitudinal trends among patients with acne.

Background Despite acne being a common dermatological problem, there is a paucity of literature addressing the knowledge, attitude and practice about it. Aims/Objectives To find out what patients know about acne, its cause and treatment, as well as myths, misconceptions and attitude towards it. Methods A cross-sectional, descriptive questionnaire-based study on acne patients at Maharana Bhupal Hospital, RNT Medical College, Udaipur, Rajasthan, India. Results Most (84.8%) patients belonged to the age group of 16-25 years. The majority (63.9%) presented 12 months after the onset of acne. More than half had average knowledge, a positive attitude and good practices, related significantly to gender and education. Limitations A standardized questionnaire suitable for all dialects and regional languages would have yielded more uniform results. Conclusion Study revealed that acne patients still need to acquire accurate, adequate and easily accessible information to seek timely and appropriate treatment, and alleviate their psychological suffering.

Cross-sectional study of acral melanoma awareness in a group of South African final phase medical students.

BACKGROUND: Acral melanoma refers to melanoma arising on the palms, soles and nail unit, which are sun-protected areas and ultraviolet exposure is not a risk factor. Acral melanoma is associated with a poorer prognosis than other melanoma subtypes most likely due to the high rates of delayed diagnosis. Acral melanoma affects all skin types equally. There is a misconception that people with more pigmented skin types (Fitzpatrick 4-6) do not develop melanoma, due to the protective effect of melanin. OBJECTIVES: The aim of the study was to determine acral melanoma knowledge and awareness of a group of South African, final phase medical students. METHODS: This was a quantitative and cross-sectional study. A questionnaire consisting of 20 clinical images of skin lesions requiring a diagnosis and management plan was distributed. Responses to six images of melanomas were analysed. Further questions to measure acral melanoma knowledge and related issues were included in the study. A biostatistician appropriately managed statistical analysis. RESULTS: Hundred and one final phase medical students' answers were gathered and analysed. Only 7.9% of the participants diagnosed all six melanomas correctly; 61.4% correctly diagnosed ≥50% of the melanomas. While 77.2% of the participants identified all non-acral cutaneous melanoma correctly, only 8.9% identified all acral melanomas. However, of all participants making the correct diagnosis, >90% selected the appropriate management plan (urgent referral). LIMITATIONS: This study examined a small sample of trainee healthcare workers. The results cannot be assumed to apply to all South African healthcare workers. Responses given in a questionnaire may not reflect actual behaviour. The dermatology division in question has made acral melanoma a research priority, thus acral melanoma knowledge in this group may in fact be better than in other institutions. CONCLUSION: The present study demonstrates that groups of imminent doctors have low rates of recognition of melanoma, particularly acral melanoma. This is consistent with high levels of primary misdiagnosis of acral melanoma reported in the literature. Fortunately, these participants managed the melanomas they diagnosed appropriately in >90% of cases. This confirms that the deficit in the participant group is awareness and knowledge. Those aware of the disease immediately acknowledged the need for urgent referral.

Knowledge, attitudes and practices of health professionals towards people living with lymphoedema caused by lymphatic filariasis, podoconiosis and leprosy in northern Ethiopia.

BACKGROUND: Podoconiosis, lymphatic filariasis and leprosy are highly stigmatised neglected tropical diseases that cause lymphoedema. Their enormous impacts on health-related quality of life, mental health and economic productivity can be significantly reduced by morbidity management and disability prevention (MMDP) services, but to deliver such services requires appropriate training of healthcare professionals. The aim of this study was to assess the knowledge, attitudes and practices (KAP) of rural Ethiopian healthcare professionals towards people with lymphoedema as a way to assess training needs. METHODS: This study used questionnaires to quantitatively assess KAP towards people with lymphoedema among rural healthcare professionals in northwest Ethiopia before and 12 months after a short training intervention. RESULTS: Questionnaires were administered to 14 health professionals at baseline and 21 at follow-up. At baseline, 71% (10/14) were found to hold at least one stigmatising attitude towards lymphoedema patients, compared with 66% (14/21) at follow-up. Large gaps in knowledge were noted, with many unable to identify ways of treating/preventing the diseases. CONCLUSIONS: This study showed high proportions of healthcare workers holding stigmatising views and lacking essential knowledge about lymphoedema. To maximise the impact of MMDP interventions, further research is urgently needed to understand how to address these issues.

Knowledge and attitude about disabilities in leprosy: Effects of an intervention grounded on the Meaningful Learning Theory / Conocimiento y actitud en relación a las incapacidades en casos de lepra: efectos de una intervención basada en la Teoría del Aprendizaje Significativo / Conhecimento e atitude sobre incapacidades na hanseníase: efeitos de intervenção fundamentada na Teoria da Aprendizagem Significativa

Abstract Objective: To analyze the effects of an educational intervention in the light of the Meaningful Learning Theory on the knowledge and attitude of Primary Health Care physicians and nurses in the assessment of the degree of physical disability in leprosy. Method: An intervention study of the before-and-after type, conducted with 122 professionals (84 nurses and 38 physicians) from the Primary Health Care of João Pessoa, Paraíba, in a training course on the assessment of the degree of physical disability in leprosy. The data were collected with the research's own instrument validated and analyzed by the chi-square adherence and proportion test, with a 5% significance level. Results: There was an increase in the scores of all items of the instrument, with a statistically significant difference (p < 0.05) in 20 of the 32 items, with emphasis on those related to the professional's technical ability to conduct the stages of anamnesis, palpation of peripheral nerves, sensory and motor evaluation. It is also noteworthy that, after the intervention, 5 items obtained 100% of correct answers. Conclusion: The educational intervention grounded on the Meaningful Learning Theory improved the health professionals' knowledge and attitude in the assessment of the degree of physical disability in people with leprosy.

RESUMEN Objetivo: Analizar los efectos de una intervención educativa a la luz de la Teoría del Aprendizaje Significativo sobre el conocimiento y la actitud de los médicos y enfermeros de la Atención Primaria de la Salud en la evaluación del grado de discapacidad física en casos de lepra. Método: Estudio de intervención antes y después, realizado con 122 profesionales, 84 enfermeras y 38 médicos, de Atención Primaria de la Salud en João Pessoa, Paraíba, en un curso de capacitación sobre la evaluación del grado de discapacidad física en lepra. Los datos se recolectaron mediante un instrumento validado y se analizaron mediante la prueba de chi-cuadrado de adherencia y proporción, con nivel de significancia del 5%. Resultados: Hubo un aumento en las puntuaciones de todos los ítems del instrumento, con diferencia estadísticamente significativa (p < 0.05) en 20 de los 32 ítems, con énfasis en los ítems referentes a la capacidad técnica del profesional para realizar los pasos de la anamnesis, palpación de los nervios periféricos, evaluación sensorial y motora. Además, es de destacar que luego de la intervención, 5 ítems obtuvieron respuestas 100% correctas. Conclusión: La intervención educativa basada en la Teoría del Aprendizaje Significativo mejoró el conocimiento y la actitud de los profesionales de la salud en la evaluación del grado de discapacidad física de las personas con lepra.

RESUMO Objetivo: Analisar os efeitos de uma intervenção educativa à luz da Teoria da Aprendizagem Significativa sobre o conhecimento e a atitude de médicos e enfermeiros da atenção básica de saúde na avaliação do grau de incapacidade física na hanseníase. Método: Estudo de intervenção do tipo antes e depois, realizado com 122 profissionais, sendo 84 enfermeiros e 38 médicos, da Atenção Básica de Saúde de João Pessoa, Paraíba, em curso de capacitação sobre avaliação do grau de incapacidade física na hanseníase. Os dados foram coletados com instrumento próprio validado e analisados pelo teste qui-quadrado aderência e de proporção, com nível de significância de 5%. Resultados: Houve aumento dos escores de todos os itens do instrumento, com diferença estatisticamente significativa (p < 0,05) em 20 dos 32 itens, com destaque para os itens referentes à capacidade técnica do profissional para conduzir as etapas de anamnese, palpação dos nervos periféricos, avaliação sensitiva e motora. Destaca-se também que após a intervenção 5 itens obtiveram 100% de acertos. Conclusão: Intervenção educativa pautada na Teoria da Aprendizagem Significativa aperfeiçoou o conhecimento e a atitude dos profissionais de saúde na avaliação do grau de incapacidade física de pessoas com hanseníase.

Territory, neglected diseases and the action of community and endemic combat agents / Território, doenças negligenciadas e ação de agentes comunitários e de combate a endemias

ABSTRACT OBJECTIVE To characterize knowledge, practices, and professional experience of community health agents (ACS) and endemic combat agents (ACE) on leprosy and Chagas disease (DC), during participation in an integrated training workshop in the IntegraDTNs-Bahia project. METHODS Descriptive and exploratory case study, involving health agents and endemic combat agents participating in a training workshop on the shared role of these professionals in health care and surveillance processes. The project was developed in the municipalities of Anagé, Tremedal and Vitória da Conquista, in the southwestern State of Bahia, 2019-2020. A specific instrument was applied, with questions related to knowledge and practices of surveillance and care for leprosy and Chagas disease. Descriptive analysis of the data, in addition to consolidation of the lexical analysis, was performed. RESULTS Out of a total of 135 participants (107 ACS and 28 ACE), 80.7% of them have been working for at least 12 years, without previous participation in joint training processes. Only 17.9% of endemic combat agentes reported having participated in training on leprosy and none reported developing specific actions to control the disease. For Chagas disease, 36.4% of community health agents participated in training more than a decade before, while for 60.7% of endemic combat agents the last training was carried out in the last five years. The development of educational actions for Chagas disease was more frequent for endemic combat agents (64.3%). When asked about ways of recognizing diseases, the term "skin spots" was the most reported (38 times) for leprosy and, for Chagas disease, the term "I don't know" (17 times). CONCLUSION Processes of health agents and endemic combat agents action in realities endemic for leprosy and Chagas disease in the interior of Bahia proved to be fragmented in the territories. For these diseases, the distance between surveillance and health care actions is reinforced, including in training processes. The importance of innovative permanent and integrated education actions is reiterated to actually promote changes in practices.

RESUMO OBJETIVO Caracterizar conhecimentos, práticas e experiência profissional de agentes comunitários de saúde (ACS) e agentes de controle de endemias (ACE) sobre hanseníase e doença de Chagas (DC), durante participação em oficina de formação integrada no projeto IntegraDTNs-Bahia. MÉTODOS Estudo de caso descritivo e exploratório, envolvendo comunitários de saúde e agentes de controle de endemias, participantes de oficina de formação sobre o papel compartilhado desses profissionais no processo de vigilância e atenção à saúde. Projeto desenvolvido nos municípios de Anagé, Tremedal e Vitória da Conquista, no Sudoeste do Estado da Bahia, 2019-2020. Aplicou-se instrumento específico prévio com questões relativas a conhecimentos e práticas de vigilância e atenção para hanseníase e doença de Chagas. Análise descritiva dos dados, além de consolidação da análise léxica. RESULTADOS Do total de 135 participantes (107 ACS e 28 ACE), 80,7% deles atuam há pelo menos 12 anos, sem participação prévia em processos de formação conjunta. Apenas 17,9% dos agentes de controle de endemias relataram ter participado de capacitações sobre hanseníase e nenhum informou desenvolver ações específicas de controle da doença. Para a doença de Chagas, 36,4% dos agentes comunitários de saúde participaram de capacitações há mais de uma década, enquanto para 60,7% dos agentes de controle de endemias a última capacitação foi realizada nos últimos cinco anos. O desenvolvimento de ações educativas para a doença de Chagas foi mais frequente para agentes de controle de endemias (64,3%). Quando perguntados sobre formas de reconhecimento das doenças, a palavra "manchas na pele" foi a mais relatada (38 vezes) para hanseníase e, para a doença de Chagas, a palavra "não sei" (17 vezes). CONCLUSÃO Os processos de atuação de agentes comunitários de saúde e agentes de controle de endemias em realidades endêmicas para hanseníase e doença de Chagas no interior da Bahia revelaram-se desintegrados nos territórios. Para essas doenças, reforça-se o distanciamento entre ações de vigilância e de atenção à saúde, inclusive nos processos de capacitação. Reitera-se a importância de ações inovadoras de educação permanentes e integradas para promover de fato mudanças nas práticas.

Nursing care for the Amazon population: knowledge production and human resource development / Atención de enfermería a la población amazónica: producción de conocimiento y formación de recursos humanos / Cuidado de enfermagem à população amazônica: produção de conhecimento e formação de recursos humanos

ABSTRACT Objectives: to analyze knowledge production adherence from a master's course in nursing in the Amazon to care and health demands in the region, with an emphasis on neglected tropical diseases and traditional populations in the Amazon. Methods: a descriptive study, with a quantitative approach and documentary basis, analyzing dissertations defended in a Graduate Program in Nursing at the Universidade do Estado do Pará in association with the Universidade Federal do Amazonas, from 2012-2019. A descriptive statistical analysis was performed. Results: of the 105 dissertations analyzed, 30 (28.6%) were related to neglected tropical diseases. Of these, 11 (10.5%) dealt with Chagas disease, leishmaniasis, tuberculosis, malaria, and leprosy. Traditional populations in the Amazon participated in only 11 (10.5%) studies. Conclusions: knowledge production in a master's course has adherence to care and health demands in the region; however, it needs to enhance its production to strengthen its identity.

RESUMEN Objetivos: analizar la adherencia de la producción de conocimiento de una maestría en enfermería en la Amazonía a las demandas de atención y salud en la región, con énfasis en las enfermedades tropicales desatendidas y las poblaciones tradicionales de la Amazonía. Métodos: estudio descriptivo, con enfoque cuantitativo, con base documental, de las tesis defendidas en el Programa de Posgrado en Enfermería de la Universidade do Estado do Pará en asociación con la Universidade Federal do Amazonas, en el período 2012-2019. Se realizó análisis estadístico descriptivo. Resultados: de las 105 disertaciones analizadas, 30 (28,6%) estaban relacionadas con enfermedades tropicales desatendidas. De estos, 11 (10,5%) se ocuparon de la enfermedad de Chagas, leishmaniasis, tuberculosis, malaria y lepra. La participación de poblaciones tradicionales amazónicas se evidenció en solo 11 (10,5%) estudios. Conclusiones: la producción de conocimiento del Máster analizado tiene apego a las demandas de atención y salud de la región amazónica, sin embargo, necesita potenciar su producción para fortalecer su identidad.

RESUMO Objetivos: analisar a aderência da produção de conhecimento de um curso de mestrado em enfermagem na Amazônia às demandas de cuidado e saúde da região, com ênfase nas doenças tropicais negligenciadas e populações tradicionais da Amazônia. Métodos: estudo descritivo, de abordagem quantitativa, de base documental, das dissertações defendidas no Programa de Pós-Graduação em Enfermagem da Universidade do Estado do Pará em associação com a Universidade Federal do Amazonas, no período de 2012-2019. Foi realizada a análise estatística descritiva. Resultados: das 105 dissertações analisadas, 30 (28,6%) estavam relacionados às Doenças Tropicais Negligenciadas. Destas, 11 (10,5%) versavam sobre doença de Chagas, leishmaniose, tuberculose, malária e hanseníase. A participação de populações tradicionais da Amazônia foi evidenciada em apenas 11 (10,5%) estudos. Conclusões: a produção de conhecimento do curso de mestrado analisado possui aderência às demandas de cuidado e saúde da região amazônica, todavia, necessita potencializar sua produção para fortalecer sua identidade.

Disabilities in leprosy: construction and validation of instrument on knowledge and attitude of professionals / Discapacidades en la lepra: construcción y validación de un instrumento sobre el conocimiento y la actitud de los profesionales / Incapacidades na hanseníase: construção e validação de instrumento sobre conhecimento e atitude de profissionais

ABSTRACT Objective: To develop and test the content validity of the "Knowledge and Attitudes on Assessing Degrees of Physical Disability in Leprosy" instrument. Methods: Methodological study carried out between January and May 2019 in three stages: item generation, analysis of aggregated redundancy to the composition, and content validation, using the Delphi technique. Results: In the first evaluation, a relevance of ≥ 0.80 stood out for all items, except for 2.8, which was excluded. To make the instrument clearer, the sequence was renumbered from one to 32; 2.6, 3.1, and 15 were reformulated, and the others underwent modifications, except for ten and 13. After the second evaluation, all items obtained Content Validity Index > 0.90 and Kappa = 1.00. Conclusion: The instrument has an excellent content validity; it is inferred that it is adequate to measure the knowledge and attitudes of professionals in the assessment of physical disabilities in leprosy.

RESUMEN Objetivo: Construir y testar la validez de contenido del instrumento "Conocimiento y Conducta acerca de Evaluación del Grado de Discapacidad Física en la Lepra". Métodos: Estudio metodológico realizado entre enero y mayo de 2019 en tres etapas: generación de ítems, análisis de redundancia agregada a la composición y validez de contenido, utilizando técnica Delphi. Resultados: En la primera evaluación, destacó relevancia ≥ 0,80 para todos ítems, excepto para 2.8, que fue excluido. Para volver el instrumento más claro, la secuencia fue renumerada de 1 a 32; 2.6, 3.1 y 15 fueron reformulados, y los demás pasaron por modificaciones, excepto 10 y 13. Después de la segunda evaluación, todos ítems obtuvieron Índice de Validez de Contenido > 0,90 y Kappa = 1,00. Conclusión: Instrumento posee validez de contenido excelente; infiere que es adecuado para mensurar los conocimientos y conductas de profesionales acerca de evaluación de las discapacidades físicas en la Lepra.

RESUMO Objetivo: Construir e testar a validade de conteúdo do instrumento "Conhecimento e Atitude sobre a Avaliação do Grau de Incapacidade Física na Hanseníase". Métodos: Estudo metodológico realizado entre janeiro e maio de 2019 em três etapas: geração de itens, análise de redundância agregada à composição e validação de conteúdo, utilizando a técnica Delphi. Resultados: Na primeira avaliação, destaca-se relevância ≥ 0,80 para todos os itens, exceto para 2.8, que foi excluído. Para tornar o instrumento mais claro, a sequência foi renumerada de 1 a 32; 2.6, 3.1 e 15 foram reformulados, e os demais passaram por modificações, exceto 10 e 13. Após a segunda avaliação, todos os itens obtiveram Índice de Validade de Conteúdo > 0,90 e Kappa = 1,00. Conclusão: O instrumento possui validade de conteúdo excelente; infere-se que é adequado para mensurar os conhecimentos e as atitudes dos profissionais sobre a avaliação das incapacidades físicas na hanseníase.

Knowledge of and Attitude Toward Leprosy in a Leprosy Endemic District, Eastern Ethiopia: A Community-Based Study.

INTRODUCTION: Leprosy or Hansen's disease is a potentially disabling disease that results in discrimination and self-stigma. A delay in case detection among leprosy patients is one of the factors resulting in disability. Although poor insights of the community toward leprosy lead to delays in case detection, studies on such matters are neglected in Ethiopia. OBJECTIVE: To assess the level of community knowledge and attitudes toward leprosy in Fedis District, Eastern Ethiopia. METHODS: A community-based cross-sectional study was carried out among 728 randomly selected households from July to August 2019. Each participant was interviewed using a pretested structured questionnaire consisting of participants' socio-demographic background, questions related to knowledge of and attitudes toward leprosy. The collected data were entered using EpiData 3.1 and analyzed using STATA version 13. Chi-squared test, binary, and multivariable logistic regressions were applied as appropriate to assess the association between outcome and independent variables. RESULTS: Among 728 study participants, 608 (83.52%) of them had heard about leprosy. Among the study participants who had heard of leprosy, 346 (56.91%) of them had high knowledge of leprosy. Multivariable logistic regression revealed that study participants who completed grade 1-8 (AOR=1.68, 95% CI=1.09-2.58, P=0.017) and government employees (AOR=7.56, 95% CI=2.23-25.63, P=0.001) were significantly associated with high level of knowledge of leprosy. Out of 608 study participants who had heard of leprosy, only 248 (40.79%) had a favorable attitude toward leprosy. Study participants who completed grade 1-8 (AOR= 2.72, 95% CI=1.76-4.19, P= 0.000) and urban inhabitants (AOR=0.49, 95% CI=0.31-0.75, P= 0.032) were significantly associated with favorable attitude toward leprosy. Having high knowledge of leprosy was significantly associated with favorable attitudes toward leprosy. CONCLUSION: This study revealed unfavorable attitudes toward leprosy among the community. Having a high overall knowledge level on leprosy has been shown to support a favorable attitude toward leprosy.

Baixo conhecimento de doadores de sangue sobre a hanseníase como fator de vulnerabilidade para a disseminação da doença / Low knowledge of blood donors about leprosy as a vulnerability factor for the spread of the disease

Objetivo: caracterizar o doador de sangue e seu conhecimento sobre a hanseníase, visando contribuir para identificar pontos de vulnerabilidade sobre a doença. Metodologia: foram entrevistados doadores de sangue (n=199) através de um questionário estruturado abordando características socioeconômicas e o conhecimento sobre a hanseníase. Para a análise dos dados foi utilizado o método de Goodman e considerado significativo p<0,05. Resultados: dentre as perguntas sobre a hanseníase, a maioria dos participantes (65,83%) não tinha conhecimento da doença e nem o seu modo de transmissão (75,88%) e quando computado o conhecimento da Hanseníase, 1,51% conheciam, 39,70% conheciam pouco e 58,79% não conheciam a doença. Nossos resultados demonstraram que somente a escolaridade teve associação significativa com a falta de conhecimento sobre a hanseníase (p=0,0273). Conclusão: verificou-se déficit de conhecimento da população geral quanto à hanseníase. Sugerimos um aprimoramento da divulgação das informações quanto à doença a fim de promover melhoras nos serviços de saúde, acompanhamento dos doentes e prevenção da população saudável.

Objective: to characterize the blood donor and his knowledge about leprosy, aiming to contribute to identify vulnerability points about the disease. Methodology: blood donors (n=199) were interviewed through a structured questionnaire addressing socioeconomic characteristics and knowledge about leprosy. For the data analysis, the Goodman method was used and considered significant p<0.05. Results: Among the questions about leprosy, most participants (65.83%) did not know about the disease and its mode of transmission (75.88%) and when computing the knowledge of leprosy, 1.51% knew, 39,70% knew little and 58.79% did not know the disease. Our results showed that only schooling had a significant association with the lack of knowledge about leprosy (p=0,0273). Conclusion: there was a lack of knowledge of the general population regarding leprosy. We suggest an improved dissemination of information about the disease to promote improvements in health services, patient monitoring and prevention of the healthy population.

Aceitabilidade da quimioprofilaxia em área endêmica para a hanseníase: projeto PEP-Hans Brasil / Acceptability of chemoprophylaxis in an endemic area for leprosy: the PEP-Hans Brazil Project / Aceptabilidad de la quimioprofilaxis en un área endémica de hanseniasis: Proyecto PEP-Hans Brasil

Resumo: O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina em dose única (PEP) entre os contatos, casos índices de hanseníase e profissionais da saúde e fatores relacionados que possam influenciar na adesão. Realizou-se um estudo qualitativo de análise de conteúdo após aplicação de entrevistas semiestruturadas segundo protocolo proposto no programa LPEP (2016), realizado em Alta Floresta, Mato Grosso, Brasil, em julho de 2016. Participaram do estudo indivíduos notificados com hanseníase, contatos e profissionais da saúde. Utilizou-se o software QRS NVivo versão 10. Foram contatados 80 indivíduos, sendo 54 (67%) contatos, 11 (14%) casos índices e 15 (19%) profissionais de saúde. Dentre os contatos, 94% (51/54) tomaram PEP. Foram identificadas 3 categorias quanto à PEP: compreensão, aceitação e expectativa da intervenção. A compreensão se mostrou relacionada ao cuidado da equipe de saúde. Aceitar ou não a medicação revelou-se relacionada ao medo, confiança e proteção, operacionalidade da estratégia, autoestima e insegurança quanto à intervenção. A expectativa da intervenção relacionou-se ao bem-estar, prevenção da doença e de sequelas, diminuição de gastos públicos e ampliação do acesso. Houve reconhecimento da relevância da estratégia PEP pela possibilidade de interrupção da cadeia de transmissão, diminuição de casos novos e melhora na qualidade de vida. A insegurança em tomar a medicação e de a doença se manifestar influenciaram negativamente à aceitação da PEP; por outro lado, as informações prévias sobre a estratégia PEP contribuíram para o fortalecimento da confiança nos profissionais de saúde e para a aceitabilidade da medicação(AU).

Abstract: The aim was to analyze the acceptability of chemoprophylaxis with single-dose rifampicin (PEP) in contacts, index leprosy cases, and health professionals and related factors that can influence adherence. A qualitative content analysis study was performed after application of semi-structured interviews according to the protocol proposed in the LPEP program (2016) drafted at Alta Floresta, Mato Grosso State, Brazil, in July 2016. Study participants included individuals with leprosy, contacts, and health professionals. The QRS NVivo software version 10 was used. A total of 80 individuals were contacted, including 54 (67%) contacts, 11 (14%) index cases, and 15 (19%) health professionals. 94% of the contacts (51/54) took PEP. Three PEP categories were identified: understanding, acceptance, and expectation towards the intervention. Understanding proved to be related to care by the health team. Acceptance (or lack thereof) of the medication was related to fear, trust, and protection, the strategy's operability, self-esteem, and insecurity regarding the intervention. Expectation towards the intervention was related to wellbeing, prevention of the disease, sequelae, decrease in public expenditures, and expanded access. Participants acknowledged the relevance of the PEP strategy based on the possibility of interrupting the transmission chain, reduction in new cases, and improved quality of life. Insecurity in taking the medication and the possibility of the disease manifesting itself had a negative influence on acceptance of PEP, while prior information on the PEP strategy helped strengthen trust in the health professionals and the medication's acceptance(AU).

Resumen: El objetivo fue analizar la aceptabilidad de la quimioprofilaxis con rifampicina en dosis única (PEP) entre los contactos, casos índices de hanseniasis y profesionales de salud, así como los factores relacionados que puedan influenciar en la adhesión al tratamiento. Se realizó un estudio cualitativo de análisis de contenido, tras la realización de entrevistas semiestructuradas, según el protocolo propuesto en el programa LPEP (2016), realizado en Alta Floresta, Mato Grosso, Brasil, en julio de 2016. Participaron en el estudio individuos diagnosticados con hanseniasis, contactos y profesionales de la salud. Se utilizó el software QRS NVivo versión 10. Se contactó con 80 individuos, siendo 54 (67%) contactos, 11 (14%) casos índices y 15 (19%) profesionales de salud. Entre los contactos 94% (51/54) tomaron PEP. Se identificaron 3 categorías respecto a la PEP: comprensión, aceptación y expectativa de intervención. La comprensión estuvo relacionada con el cuidado del equipo de salud. El aceptar o no la medicación estuvo relacionado con el miedo, confianza y protección, operatividad de la estrategia, autoestima e inseguridad de la intervención. La expectativa de la intervención estuvo relacionada con el bienestar, prevención de la enfermedad, así como secuelas, disminución de gasto público y ampliación del acceso. Existió un reconocimiento de la relevancia de la estrategia PEP por la posibilidad de interrupción de la cadena de transmisión, disminución de casos nuevos y mejora en la calidad de vida. La inseguridad en tomar la medicación y de que la enfermedad se manifestara influenciaron negativamente en la aceptación de la PEP, por otro lado, la información previa sobre la estrategia PEP contribuyó al fortalecimiento de la confianza en los profesionales de salud y a la aceptabilidad de la medicación(AU).

Hanseníase: conhecimentos teóricos e práticos de profissionais de enfermagem que atuam na atenção básica / Hansen's disease: theoretical and practical knowledge of nursing professionalsworking in primary care

Introdução: A hanseníase é uma doença que necessita de busca ati-va de novos casos, diagnóstico precoce, tratamento adequado, con-trole e monitoramento. Deste modo, é de vital importância que os profissionais estejam preparados para reconhecê-la e tratá-la de for-ma adequada e eficaz. O Objetivo do estudo foi identificar o nível de informação dos enfermeiros que atuam nas unidades de saúde de Bauru/SP, acerca da hanseníase. A pesquisa foi realizada por meio da aplicação de um questionário com 6 questões que dispôs sobre as formas clínicas, diagnóstico, exames, tratamento e busca de no-vos casos da hanseníase. Para o tratamento dos dados, utilizou-se método de estatística descritiva e de associação, no qual foi reali-zada a análise individual e da amostra conjunta, observando-se a quantidade e a qualidade do nível de informação. Foram analisados 42 questionários respondidos pelos profissionais. Destes, somente 4 (9,54%) enfermeiros acertaram as 5 perguntas referentes à patologia, sendo a sexta pergunta referente à ação da unidade com relação à busca ativa. Sobre a categoria formas clínicas, 35 (83,33%) sabem quais são as corretas; na categoria diagnóstico, 19 (45,23%) sabem que ele é clínico e na categoria tratamento, 31 (73,80%) não sabem a diferença entre os paucibacilares e os multibacilares. Na categoria Busca Ativa, 18 (56,25%) não possuem conhecimento suficiente para realizá-la com qualidade. Considerações finais: Os enfermeiros (as) das Unidades Básicas de Saúde e Estratégias de Saúde da Família de Bauru/SP não possuem nível de informação suficiente para realizar um atendimento de qualidade aos pacientes acerca da patologia, ne-cessitando, assim, de uma capacitação para obterem o domínio que os possibilite prestar uma assistência adequada.

Introduction: Leprosy is a disease that requires an active search for new cases, early diagnosis, appropriate treatment, control, and monitoring. Therefore, it is of vital importance that professionals be prepared to recognize and treat it properly and effectively. The objective of the study was to identify the level of information about leprosy among nurses working in health units in Bauru/SP. The research was carried out by the application of a questionnaire comprised of six questions about clinical forms, diagnosis, tests, treatment, and search for new cases of leprosy. A method of descriptive statistics and association with individual and joint sample analysis was used to treat data, observing the quantity and quality of the level of information. Forty-twoquestionnaires answered by professionals were analyzed. Out of these, only 4 (9.54%) nurses answered correctly the 5 questions regarding pathology. Regarding the category of clinical forms, 35 (83.33%); regarding the diagnosis, 19 (45.23%) know that it is performed clinically; and the treatment, 31 (73.80%) do not know the difference between paucibacillary and multibacillary. In the Active Search category, 18 (56.25%) do not have enough knowledge to perform it with quality. Final considerations: The nurses of the Basic Units of Health and Family Health Strategies of Bauru/SP do not have enough level of information to perform quality service to patients about the pathology. Thus, they need the training to obtain the domain that allows them to provide adequate assistance

Conocimientos, creencias, percepciones y la búsqueda de tratamiento para la lepra en Costa Rica / Knowledge, beliefs and perceptions regarding leprosy treatment seeking in Costa Rica

Resumen: Objetivo: Identificar conocimientos, creencias y percepciones relacionadas con la búsqueda del tratamiento de la lepra en Costa Rica desde la perspectiva de la persona con la enfermedad y en el contexto de la vida cotidiana. Métodos: Se llevó a cabo un estudio cualitativo de carácter exploratorio a partir de 24 entrevistas semi-estructuradas a personas con lepra o con antecedente de haber padecido lepra entre 23 a 88 años de edad que se atendieron en el sistema de salud público costarricense. Se utilizó una selección de informantes. Resultados: Los informantes no consultaron hasta que los síntomas fueron difíciles de manejar. En cuanto a las creencias sobre cómo adquirieron la lepra, algunos informantes desconocen su causa. Los sentimientos de vulnerabilidad en relación con este padecimiento y valoración de la gravedad de los síntomas percibidos como también la revaluación de algunos signos de alarma que son comunes a la lepra no fueron atribuidos a la enfermedad, a pesar de poseer antecedentes-familiares. Para muchos de los informantes la palabra lepra tiene connotaciones sociales de oprobio, y la consecuencia es que la propia persona que padece lepra se estigmatiza al sentirse un "leproso identificable". Conclusión: La forma en que las personas interpretan la lepra influye en la búsqueda de ayuda. Urge la implementación de acciones de capacitación dirigidas a las personas con lepra, sus familias, comunidades y personal de salud para generar abordajes articulados y efectivos que permitan prevenir la enfermedad o una detección oportuna.

Abstract Objective: Identify knowledge, beliefs and perceptions regarding treatment seeking in Costa Rica from the perspective of the person with the disease and in daily life context. Methods: An exploratory qualitative study was carried out based on 24 semi-structured interviews with people with leprosy or leprosy history between 23 and 88 years old who were treated by the Costa Rican Public Health System. Informants´ selection was used. Results: Informants did not attend to medical care until the symptoms were difficult tomanage. For beliefs about how they got leprosy, some of them do not know their cause. Despite the fact that most of them have a family history, vulnerability feelings in relation to their condition, severity assessment of perceived symptoms as well as some warning signs that are common to leprosy were not attributed to it. For many informants the word leprosy has social opprobrium meaning, and the consequence is that the person who suffers leprosy stigmatizes himself as an"identifiable leper." Conclusion: The way people understand leprosy influence help seeking. Information actions must be aimed to people with leprosy, their families, communities and health care providers in order to generate articulated and effective approaches for disease prevention or timely detection.

Knowledge on leprosy and its management among primary healthcare providers in two districts of Bangladesh.

BACKGROUND: In 2013, Lepra Bangladesh (a non-government organization) and the National Leprosy Programme of the Directorate General of Health Services under the Ministry of Health and Family Welfare, Bangladesh implemented a 3 years project entitled "2015 and Beyond: Poverty Reduction through Strengthened Health Systems". The aims of this Health System Strengthening (HSS) project were to improve quality of leprosy services through service delivery, capacity development, curriculum development, improved collaboration, coordination, operational research and knowledge sharing to identify and treat leprosy in order to contribute to strengthen existing health systems. We evaluated the changes in knowledge of primary and community level healthcare providers about cardinal signs, course of leprosy treatment, and drug use for paucibacillary (PB) and multibacillary (MB) leprosy cases. METHODS: We conducted two surveys using purposive sampling technique in two pilot districts: Bogra and Moulvibazar. The first survey was conducted before implementing the HSS project from March to June 2014 among 98 providers. The end-line survey was conducted in November 2015 and included 49 providers. The interview was conducted using the same pre-tested structured questionnaire. Descriptive statistics followed by further analysis was done including proportions, 90% confidence intervals, and p values were calculated for the selected variables. RESULTS: The primary and community level healthcare providers demonstrated significant increases in knowledge on one cardinal sign (definite loss of sensation in a pale -hypopigmented- or reddish skin patch), doses and courses for the adult PB and MB cases and duration of Multi-Drug Therapy (MDT) course at the end line compared to the beginning of the project. All the providers except TB and Leprosy Control Assistants demonstrated statistically significant decreases in knowledge at the end-line compared to the baseline about supportive counseling. CONCLUSIONS: HSS activities including training and capacity building of the providers recorded significant increase of knowledge on types of leprosy, one cardinal sign, courses of MDT and drug use for the adult PB and MB cases and use MDT for leprosy treatment among the service providers at the end-line. Any health systems strengthening project should incorporate a capacity building approach within the programme all through.

Perception of primary health care providers of plastic surgery and its influence on referral.

OBJECTIVES: The aim of this study is to understand the level of knowledge and awareness of plastic surgery among primary health care (PHC) providers in Qassim region, Kingdom of Saudi Arabia. METHODS: This is a cross-sectional study conducted from February 2018 to March 2018 among health care providers in PHC in Qassim region, Saudi Arabia. Overall, 82 health care providers were recruited using simple random sampling. Filling the questionnaire was considered as approval to join the study. The study included general practitioners and family medicine specialists. Other specialties working in PHC were excluded from the study. RESULTS: In total, 82 physicians were enrolled in this study. Physicians considered that out of 28 listed disorders 16 of them have chosen a plastic surgeon as the best surgeon to perform the necessary surgery. The selection of plastic surgeon as the best doctor for a specific disorder was as follows: Burn deformities (93%), liposuction (87.7%), breast reduction/enhancement (86.8%), skin grating (84.4%), surgery for facial wrinkles (79.2%), electrical burns (71.6%), Botox (64.4%), cuts over the face (63.5%), abdominoplasty (62.9%), burns (59.4%), congenital anomalies of ear and nose (51.5%), deformities of leprosy (51.4%), sex change surgery (49.2%), non-healing wound over legs (47.1%), cleft lip and palate (41.7%), and totally, amputee thumb, finger, or hand (36.1%). The selection of other disorders was distributed almost similarly. CONCLUSION: General practitioners need more orientation for plastic surgery discipline. In this study, the majority of the study physicians do not have enough knowledge about the meaning of plastic surgery. As a PHC physician, knowledge about this topic is very essential because the patient is very likely to ask about the best surgeon for referral and the potential positive and negative effect of the reconstructive procedure.

Oral sex related knowledge and oral sex behavior among homosexual and heterosexual men in Belgrade: A cross-sectional study.

BACKGROUND: Although the risk of sexually transmitted infections is far greater during vaginal and anal sex than during oral sex, increasing practice of oral sex and low rates of barrier method use will probably increase the relative importance of oral sex as a route of transmission for genital pathogens. AIMS: The aim of this study was to evaluate knowledge and attitudes about oral sex and sexually transmitted infections, as well as oral sex practices, both among heterosexuals and homosexual men and to compare those two groups. MATERIALS AND METHODS: In this cross-sectional study, data were collected from consecutive sexually active male patients who ever had oral sex and who attended counselling for sexually transmitted infections at the City Institute for Skin and Venereal Diseases in Belgrade from March to June 2016. One dermatologist interviewed all participants. RESULTS: The study included 359 men who ever had oral sex, 95 (26.5%) homosexual and 264 (73.5%) heterosexual men. In comparison with heterosexual men, homosexual men had considerably more lifetime sexual partners and oral sex partners during the past 3 months, and significantly more frequently practiced oral-anal sex. Oral-sex related knowledge of all participants was unsatisfactory [correct answers were given by 95 (26.5%) to 277 (77.2%) participants], but it was significantly better in homosexual men than in heterosexual. Frequency of condom use and human immunodeficiency virus testing was also significantly higher in the case of homosexual than heterosexual men. LIMITATIONS: The study was not performed in representative sample of population. It was restricted to the patients. Consequently it is questionable whether the results obtained could be generalized. CONCLUSION: Oral sex related knowledge deficits and risky oral sex practice exist in both homosexual and heterosexual men. These findings indicate a need for effective public health campaign and patient education about the risks of unprotected oral sex.

Knowledge and practices of health practitioners on treatment of Buruli ulcer in the Mbonge, Ekondo Titi and Muyuka Health Districts, South West Region, Cameroon.

INTRODUCTION: After tuberculosis and leprosy, Buruli ulcer (BU) is the third most common mycobacterial infection. Buruli ulcer begins as a localized skin lesion that progresses to extensive ulceration thus leading to functional disability, loss of economic productivity and social stigma. This study is aimed at assessing the knowledge and practices among health practitioners on the treatment of BU in the Mbonge, Ekondo Titi and Muyuka Health Districts of the South West Region of Cameroon. METHODS: This is a cross-sectional study that investigates participants' knowledge and practices on the treatment of BU. The study uses a qualitative method of structured questionnaires in the process of data collection. RESULTS: Seventy percent (70%) of the participants acknowledged they encounter cases of BU in their respective Hospitals or Health centers. Among these, 48% agreed they managed BU in their facilities and up to 91.7% noted that their community members are aware that BU is managed in their facility while seventy percent of the medical practitioners indicated they cannot identify the various stages of BU. Eighty-one percent of the practitioners from Muyuka HD indicated they could not identify the various stages of BU. More than 63% of the practitioners regarded BU patients as normal people in their communities however, practitioners that practiced for less than 5 years were likely not to admit BU patients in the same room with other patients. Beliefs such as being cursed (47.06%) and being possessed (29.41%) were reported by practitioners that acknowledged the existence of traditional beliefs in the community. CONCLUSION: Despite the fact that a majority of the health practitioners knew what BU is, most of them demonstrated lack of knowledge on the identification of the various stages and management of the illness. Practitioners demonstrated positive attitude towards patients although they would not admit them in the same room with other patients. Considering the poor knowledge on identification and management demonstrated by most of the practitioners, management of the disease would be inadequate and may even aggravate the patient's situation. Training and onsite mentorship on screening, identification and management of BU is therefore highly recommended amongst health personnel practicing in endemic areas.

Validação de instrumento para avaliação do conhecimento de adolescentes sobre hanseníase / Validación del instrumento para la evaluación del conocimiento de los adolescentes sobre la hanseniasis / Validation of an instrument for the evaluation of adolescents' knowledge about Hansen's disease

Resumo Objetivo: Construir e validar instrumentos para avaliação do conhecimento de adolescentes sobre hanseníase e caracterização dos sujeitos. Métodos: Pesquisa metodológica, desenvolvida em três etapas, a saber: construção dos instrumentos; validação de face e conteúdo com sete juízes; e validação semântica com 20 adolescentes, de 10 a 14 anos. Resultados: Houve concordância superior a 80% entre os juízes quanto a todos os domínios, itens e componentes avaliados. A concordância geral entre os juízes para o instrumento de avaliação do conhecimento de adolescentes sobre hanseníase, com 14 itens, foi de 89% e do instrumento para caracterização dos participantes, com 17 itens, foi de 93%. Na validação semântica, os instrumentos foram considerados com boa compreensão, e não houve dificuldades para seu preenchimento. Entre os adolescentes, 10% afirmaram ter ou ter tido casos de hanseníase na família. A maioria dos adolescentes (55%) nunca tinha ouvido falar ou tinha recebido informações sobre hanseníase, assim como a maioria (60%) afirmou não saber o que era a hanseníase. Conclusão: Os instrumentos construídos para avaliar o conhecimento de adolescentes sobre hanseníase e caracterizar a população estudada foram considerados válidos quanto à face, ao conteúdo e à semântica. Ambos os instrumentos apresentaram aparência, compreensão e relevância consideradas muito boas ou excelentes, podendo ser aplicados ao público de estudo.

Resumen Objetivo: Construir y validar instrumentos para evaluar el conocimiento de adolescentes sobre hanseniasis y caracterización de los sujetos. Métodos: Investigación metodológica desarrollada en tres etapas, a saber: construcción de los instrumentos, validación de cara y contenido con siete jueces y validación semántica con 20 adolescentes de 10 a 14 años. Resultados: Hubo correspondencia superior al 80% entre los jueces en cuanto a todos los elementos, ítems y componentes evaluados. La correspondencia general entre los jueces para el instrumento de evaluación del conocimiento de adolescentes sobre hanseniasis, con 14 ítems, fue del 89%, y del instrumento para caracterización de los participantes, con 17 ítems, fue del 93%. En la validación semántica los instrumentos fueron considerados con buena comprensión y no hubo dificultades para su diligenciamiento. Entre los adolescentes, el 10% afirmó tener o haber tenido casos de hanseniasis en la familia. La mayoría de los adolescentes (55%) nunca había oído hablar o había recibido información sobre la hanseniasis, así como la mayoría (60%) afirmó no saber lo que era la hanseniasis. Conclusión: Los instrumentos construidos para evaluar el conocimiento de adolescentes sobre hanseniasis y caracterizar a la población estudiada fueron considerados válidos en cuanto a la cara, el contenido y la semántica. Ambos instrumentos presentaron apariencia, comprensión y relevancia consideradas muy buenas o excelentes, por lo que se pudieron aplicar al público estudiado.

Abstract Objective: To construct and validate instruments for the evaluation of adolescents' knowledge about Hansen's disease and characterization of these subjects. Methods: Methodological study developed in three steps, namely: construction of instruments; face and content validation with seven judges; and semantic validation with 20 adolescents aged from 10 to 14 years. Results: There was more than 80% agreement among judges in all domains, items and components evaluated. The general agreement among judges for the instrument for evaluation of adolescents' knowledge on Hansen's disease with 14 items was 89%, and for the instrument for characterization of participants with 17 items, agreement was 93%. In the semantic validation, the instruments were considered of good understanding, and there were no difficulties for completing them. Among adolescents, 10% reported having or having had cases of Hansen's disease in the family. Most adolescents (55%) had never heard of or received information about Hansen's disease, and most (60%) also said they did not know what Hansen's disease was. Conclusion: The instruments constructed to evaluate adolescents' knowledge about Hansen's disease and to characterize the studied population were considered valid regarding face, content and semantics. The appearance, comprehension and relevance were considered as very good or excellent in both instruments, and they can be applied to the target population.

An Appalachian Perspective of Alzheimer's Disease: A Rural Health Nurse Opportunity.

Predictions of the devastating impact of Alzheimer's disease (AD) are heightened in disadvantaged rural populations, yet studies investigating AD in this population are limited. Other researchers have shown that when rural Appalachian people are aware of their risk for a chronic illness, they are more willing to adopt healthy behaviors (Della, 2011; Schoenberg et al. 2011), suggesting that educational programs to increase knowledge and perception of risk are needed. The purpose of this article was to report findings from exploring knowledge of Alzheimer's disease in a southern rural West Virginia community of residents (N = 193) and a sample of caregivers (n = 20) using cognitive interview techniques of "Think-aloud" and "Laddering". The cultural fit and relevance of the "Knowledge of Alzheimer's Disease scale or KAD (Jang, Kim, Hansen, & Chiriboga, 2010) was also examined. Findings from the KAD included that an updated AD measure appropriate for use in rural settings is needed. Findings from the cognitive interview included that instead of fatalistic attitudes toward Alzheimer's disease, residents often viewed AD as something potentially preventable through healthier living, use of herbs as children, and eventual discovery of more effective treatment regimens. The themes that emerged were "preventing AD" and "personal knowing of AD". Considering cultural perceptions and determining knowledge gaps in the communities by rural providers is an important component of changing stigma regarding routine cognitive screening for rural older adults at increased risk for Alzheimer's disease.

Fatores influenciadores do conhecimento dos estudantes de enfermagem sobre hanseníase: estudo transversal / Factors influencing nursing students' knowledge about hansen's disease: a cross-section study

Aim: to identify the factors that influence Nursing students' knowledge about Hansen's disease. Method: this is a cross-section study with a quantitative approach, performed from May to June 2016. The sample was composed by 167 Nursing students of a public university located in the Northeastern region of Brazil. Result: the majority of students knows the main aspects of the disease. Factors such as being single, not having another occupation or income, to live with few other people, and search for information with professor were associated to a higher level of understanding about leprosy. Female students demonstrated less chances to know about Hansen's disease. Conclusion: Nursing students know about leprosy, however there are still questions regarding the transmission of the illness.(AU)

Objetivo: identificar os fatores que influenciam o conhecimento de estudantes de Enfermagem sobre hanseníase. Método: estudo transversal, com abordagem quantitativa, realizado no período de maio a junho de 2016. A amostra foi constituída por 167 estudantes de Enfermagem de uma universidade pública do Nordeste do Brasil. Resultado: a maioria dos estudantes conhece os principais aspectos da doença. Fatores como ser solteiro, não possuir outra ocupação nem atividade remunerada, morar com poucas pessoas e buscar informações com os professores estavam associados ao maior conhecimento sobre hanseníase. Estudantes do sexo feminino demonstraram menores chances de conhecer a doença. Conclusão: os estudantes de Enfermagem possuem conhecimento sobre hanseníase, porém ainda existem dúvidas quanto ao modo de transmissão da doença.(AU)

Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia.

BACKGROUND: Leprosy is a chronic infectious disease of public health importance and one of the leading causes of permanent physical disability. Nevertheless, the drop in prevalence following multidrug therapy has resulted in the neglect of leprosy. The annual incidence of leprosy has remained the same in Ethiopia since decades with more than 76% of the reported new cases coming from Oromia and Amhara Regional States. This study was aimed to assess the knowledge, attitude and skill of general health workers in leprosy control activities at public health facilities in Oromia and Amhara Regional States. METHODS: A cross-sectional study was conducted from September 2011 to February 2012 at different public health facilities in selected eight zones in Oromia and Amhara Regional States. A multistage sampling method was used to obtain representative samples. High and low endemic zones for leprosy were included in the study in both regional states. Data were collected from general health workers through a structured self-administered questionnaire and at on-site assessment of their performance. Baseline socio-demographic data, health workers' attitude towards leprosy and their knowledge and skill in the management of leprosy were assessed. Bloom's cut off point was used to describe the knowledge and practical skills of the respondents while Likert's scale was used for attitude assessment. RESULT: A total of 601 general health workers responsible for leprosy control activities at public health facilities were included in knowledge and attitude assessment and 83 of them were subjected to practical evaluation, with on-site observation of how they handle leprosy patients. These included medical doctors (4%), health officers and nurses with Bachelor degree in Science (27%), clinical nurses with diploma (66%) and health assistants (2.8%). The median age of the respondents was 26.0 years and females made up of 45%. Generally the knowledge and skills of the respondents were found to be poor while attitude towards leprosy was positive for the majority of the respondents. The result showed that 519 (86.3%) had poor knowledge. Overall 155 (25.8%) of the respondents had positive attitude towards leprosy while 205 (34.1%) had intermediate (mixed) attitude and 241 (40.1%) had negative attitude to the disease. Among 83 respondents assessed for diagnosis of leprosy only 15(18.0%) diagnosed leprosy correctly. Variation in knowledge and attitude indicated a significant difference (p < 0.05) among different health institutions, professions, gender, in-service training and years of experience. CONCLUSION: The current finding underlines that although leprosy control activities are integrated to the general health services in the country, the knowledge and skills of leprosy diagnosis, treatment and management by health workers was unsatisfactory. Hence, attention should be given to develop training strategies that can improve health worker knowledge and promote better leprosy management at public health facilities. This could be achieved through pre-service and in-service training and giving adequate emphasis to leprosy related practical work and continuous follow- up.