JMIR Publications

ABSTRACT

Background:

In the global strategy to eliminate leprosy, the World Health Organisation emphasizes the need for early case detection to successfully interrupt transmissions. Leprosy-related stigma and poor knowledge about leprosy are key drivers of delayed diagnosis and treatment. Low literacy and language barriers are challenging the potential effectiveness of one-time sensitization campaigns to increase knowledge and reduce stigma. The the effect of such sensitization campaigns has not been studied studied in the multilingual West African context.

Objective:

We aim to test the effect of common practice community level awareness campaigns on leprosy related knowledge, attitude, and practices and stigma among community members and community health volunteers. Additionally, we will test the potential of novel audio tools in 15 most prominent local languages for overcoming literacy and language barriers and amplifying sensitization campaigns.

Methods:

We are conducting a mixed method cluster randomized controlled trial study in 60 rural communities in Togo featuring two intervention arms. Intervention and control arms are randomly assigned on community level. Communities in intervention arm 1 will receive a sensitization campaign in line with the common practice of the national neglected tropical disease program. Communities in intervention arm 2 will receive the same sensitization campaign accompanied by audio tools distributed to community households. Quantitative outcome measures on knowledge and stigma will be collected from a random sample of 1,200 individuals. We will estimate intention-to-treat effects at the individual level, comparing outcomes of intervention and control groups. We will further estimate average treatment effects on the treated, based on individual attendance to sensitization campaigns. In an accompanying qualitative component, we will conduct in-depth interviews with community members, community health volunteers and healthcare workers in both treatment groups and the control group to explore intervention and stigma-related experiences.

Results:

The baseline data collection took place in March 2023. In the 60 study communities, a total of 1200 individuals have been interviewed. Implementation of study arm 1 has been completed by September 4, 2023. Implementation of study arm 2 is planned for September 2023. Endline data collection is planned for November/December 2023.

Conclusions:

This trial will be among the first to test causal effectiveness of community-based sensitization campaigns and audio tools to increase knowledge and reduce leprosy-related stigma. As such, the results will inform health policy, decision makers, and public health practitioners designing sensitization campaigns in rural multilingual settings. Clinical Trial: DRKS-ID: DRKS00029355