02249nas a2200253 4500000000100000008004100001260001200042653002600054653002400080653001500104653003400119653001200153100001200165700001500177700001200192700001700204700001500221245012800236856006700364300000900431490000700440520153400447022001401981 2024 d bMDPI AG10aActive case detection10aActive case finding10aEndemicity10aEarly Diagnosis and Treatment10aLeprosy1 aBrown H1 aFastenau A1 aPenna S1 aSaunderson P1 aKlabbers G00aExploring Active Case Detection Approaches for Leprosy Diagnosis in Varied Endemic Settings: A Comprehensive Scoping Review uhttps://www.mdpi.com/2075-1729/14/8/937/pdf?version=1721985446 a1-150 v143 a

Background: The global burden of leprosy is not shared equally; with the majority of cases being diagnosed in Brazil, India, and Indonesia. Understanding the methods of active case detection (ACD) used in high and low endemic regions is vital for the development of future screening programs.

Methods: A systematic search of three databases, PubMed, Embase and Web of Science, was conducted for English language papers, published since the year 2000, which discussed the use of active case detection methods for leprosy screening. The paper utilised the Integrated Screening Action Model (I-SAM) as a tool for the analysis of these methods.

Results: 23 papers were identified from 11 different countries. The papers identified 6 different methods of active case detection: Household contact/social contact identification; door-to-door case detection; screening questionnaire distribution; rapid village surveys; school-based screening; and prison-based screening. 15 were located in high endemic regions and 8 of these were located in low endemic regions.

Conclusions: For selecting the appropriate methods of active case finding, the leprosy endemicity must be taken into consideration. The findings contribute to policy decision making allowing for more successful future leprosy case detection programs to be designed, ultimately reducing the global burden of the disease, and achieving the WHO’s aim of zero leprosy.

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