Culture and ‘compliance’ among leprosy patients in Pakistan

Mull, J. Dennis; Wood, Corinne Shear; Gans, Lydia P.; Mull, Dorothy S.

doi:10.1016/0277-9536(89)90079-8

Cited by 44 publications

(42 citation statements)

References 9 publications

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“…7 Education of traditional healers by trained physicians would make an additional vital impact. Short-term courses could be planned to train local traditional healers to identify early symptoms of the disease and subsequent referral, so that early detection of women patients is fe asible.…”

Section: Discussionmentioning

confidence: 99%

Gender differentials in the social impact of leprosy

Rao¹,

Garole²,

Walawalkar³

et al. 1996

Leprosy Review

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Summary Prevalence rates ofleprosy have reduced considerably in many states where multidrug therapy is in operation. However, reduction in prevalence alone is not sufficient as the social consequences of the diseases on the life of the patient are often severe and persist even after its cure. The present paper, therefore, investigates social impact with special reference to gender differentials. Data obtained from structured questionnaires (n = 606) is analysed for this purpose. It was observed that the initial delay in identifying the skin changes as the symptoms of the disease were higher for females (29 months) than males (24 months). Even after identifying the symptoms, women were observed to depend exclusively on nonmedical treatment for a longer period (10 months) than males (6 months). Upon starting the medical treatment fe males were observed to be more compliant than males, but the benefits of regularity appeared to be outweighed by the initial delay in starting medical treatment. The social impact on daily life was more severe for females than males as revealed by the isolation from daily activities, such as, restrictions on participation in fa milial functions, restrictions on touching children. The paper highlights implications of gender bias on detection and treatment, and suggests modifications for control programmes.The leprosy control programme in India aims to bring down the prevalence of leprosy to below 1/10,000. This is in accordance with the WHO declaration of the global elimination of leprosy by the year 2000 AD. 1 With the introduction of multidrug therapy (MDT), profound changes in the epidemiology of the disease have occurred, 12 with a significant reduction in the prevalence rates in many states, where MDT is in operation. 2 However, reduction in prevalence alone is not sufficient as the social consequences of the diseases on the life of the patient are often severe and persist even after its cure. The social aspects associated with this disease are therefore as important, if not more important than the biological ones. 190

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Section: Discussionmentioning

confidence: 99%

Gender differentials in the social impact of leprosy

Rao¹,

Garole²,

Walawalkar³

et al. 1996

Leprosy Review

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“…This study from Pakistan, included only women, and did not report whether the same fear was present in men. 41 This study found that the dark skin coloration associated with Clofazimine, is a big problem for many women as a dark skin is often associated with lower social status. 41…”

Section: 41 Thismentioning

confidence: 99%

Women and leprosy: a review

A¹

1997

Leprosy Review

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Summary Gender inequalities in health have a significant impact on women's health. In leprosy gender inequalities could be even more serious, as it is a highly stigmatized disease. A review has been made of the most recent literature dealing with gender and leprosy. First some data are presented on gender inequalities in rates of case detection, deformities and reversal reactions among leprosy patients. Then the major factors contributing to those differences are discussed. The paper ends with some recommendations for further research on gender and leprosy.Women's issues in health have, until recently, received little attention from health managers, policy makers and researchers. I There are, however, many gender inequalities in health which require due attention in health planning and management. Gender refers not only to sex, but also to the wide variety of social, cultural and economical variables attributed by social structures to men and women.2 Men and women experience differential health risks stemming from their social roles and expectations. Women may have a different exposure to disease and infection, and diseases may have a different impact on women, not only in a medical sense, but also in sociocultural and economical ways. Some diseases 'affect women particularly or exclusively, such.as reproductive health problems, and cervical and br�ast cancer. Other diseases affect both men and women, but have a different impact on wome ' such as nutritional morbidity, sexually transmitted diseases (STDs) and pelvic infections, and some tropical diseases such as malaria, schistosomiasis and tuberculosis. 3 Information on how women are affected differently)s, however, still limited. WOIIJ.en may have less access to health services than men, they maybe treated differently to men, and diseases may manifest themselves differently in women, requiring a different treatment approach. Gender and leprosyIn some tropical diseases, such as filariasis, and leprosy, gender inequalities may play an even larger role, because of their effect on physical appearance and the social stigma associated with them.

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“…Some of the recent literature has linked compliance to the quality of information that is provided to the patient. 7 The outcome of our study has prompted ALERT-India to enhance the educational component in its existing survey programme.…”

Section: Discussionmentioning

confidence: 98%