Background 

Skin diseases are a significant health problem worldwide, affecting a large portion of the global population. Skin diseases are particularly challenging in poorer and remote communities due to factors like poverty, crowded living conditions, limited access to healthcare, and hygiene challenges. Indonesia, particularly the eastern Nusa Tenggara Timur (NTT) province, faces a heavy burden of skin diseases, including common and neglected tropical skin diseases (skin-NTDs) like leprosy and scabies. Skin-NTDs can lead to disabilities, social stigma, and reduced quality of life. The healthcare system in these areas is often under-resourced and lacks the expertise and infrastructure to effectively address these diseases.

Previous work using teledermatology services in West and South West Sumba revealed a higher than expected number of leprosy cases, many of which were diagnosed at a late stage with visible deformities. This suggests that leprosy might be more widespread than official records indicate and highlights the need for a comprehensive study to understand the true extent of the problem. Scabies, another neglected skin disease, also poses a significant health burden in Indonesia. The country has the highest rate of disability-adjusted life-years (DALYs) due to scabies, emphasizing its impact on people’s health and well-being.

Study Design

This study will use a three-pronged approach to investigate the burden of leprosy and scabies:

• Clinic-Based Case Finding: This involves systematically identifying and diagnosing all individuals presenting with leprosy, scabies, and other skin-NTDs at Sumba Foundation clinics over a six-month period.
• Community-Based Contact Tracing: Household members and close contacts of individuals diagnosed with leprosy or scabies will be traced and screened for these diseases. This helps understand disease transmission patterns within communities.
• Community-Based Household Survey: Randomly selected areas in West and South West Sumba will be surveyed to screen all residents for leprosy and scabies. This provides a broader picture of disease prevalence in the general population.

All diagnoses will be confirmed through teledermatology consultations with expert dermatologists, ensuring accurate identification of cases.

Goal

The first objective of the study is to detect and describe new cases of leprosy and scabies in West and South West Sumba. We want to understand how these diseases are transmitted within the communities and determine the incidence, or rate of new cases, of both leprosy and scabies. The second objective of the study is to assess whether mapping the locations of cases can effectively identify high-risk areas for leprosy and assist in finding new cases through household surveys.

Status

Study is ongoing.