Perspectives on the impact of stigma in leprosy: strategies to improve access to health care

Rao, P S S

doi:10.2147/rrtm.s55903

Cited by 6 publications

(3 citation statements)

References 42 publications

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“…Stigma is one of the factors that cause delays in patients getting treatment, this is because the patient's fear will be known by others that they were infected with leprosy and are unwilling to seek medical treatment quickly. This situation does not support the process of treatment and healing, on the contrary, it will increase the risk of disability for the patient himself [8,9]. The results of this study are not in line with research conducted in Nepal, the study showed no relationship between stigma and treatment delay.…”

Section: Discussioncontrasting

confidence: 76%

Perceived Stigma as a Risk Factor for Delay in Seeking Treatment of Leprosy Patients: A Cross-Sectional Study in Tuban Regency

2020

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Tuban Regency is a leprosy endemic area. Leprosy prevalence in 2018 was 1.5 per 10,000 population with 177 new cases, about 87% of new leprosy cases are MB type and 11% have grade II disability. The high number of MB type and grade II disability leads to the low awareness of treatment-seeking behavior, as early as immediately after symptoms appear. This study aimed to prove that perceived stigma is a risk factor for delay in seeking treatment for leprosy patients. Cross-sectional study design was used in this study and the subject consisted of 112 leprosy patients, selected by proportional random sampling. Data were collected using a structured questionnaire. This study showed most of the subjects ranged from 15-60 years, more than half were male, most had low levels of education with low income. Most subjects suffered from the MB type of leprosy. More than half experienced delays in seeking treatment and did not experience disabilities. The variables such as knowledge, attitude, perceived susceptibility and severity of leprosy, and perceived stigma associated with the delay in seeking treatment, and only perceived stigma was proven as a risk factor for delay in seeking treatment of leprosy patients (p = 0.002; OR 4.458 (95% CI; 1,700-11,690)

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Section: Discussioncontrasting

confidence: 76%

Perceived Stigma as a Risk Factor for Delay in Seeking Treatment of Leprosy Patients: A Cross-Sectional Study in Tuban Regency

2020

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“…Leprosy‐related stigma is ubiquitous, and its cultural significance is its main characteristic, with impacts from the disease's religious, psychological and demographic experiences [20]. We investigated stigma using the EMIC stigma scale, finding that it was not significantly higher in women than men, as previously described [21].…”

Section: Discussionmentioning

confidence: 99%

Clofazimine‐induced cutaneous hyperpigmentation as a source of stigma in the treatment of leprosy: A cross‐sectional study

Nogueira,

Garcia,

Silva

et al. 2024

Tropical Med Int Health

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ObjectivesCutaneous hyperpigmentation is one of the main adverse effects encountered in patients undergoing leprosy treatment with multidrug therapy (WHO‐MDT). This adverse effect has been described as intolerable and capable of contributing to social stigma. The objectives of this study were to quantify the variation in skin colour induced by clofazimine during and after treatment and to assess the related stigma.MethodsThis observational cross‐sectional study objectively measured skin colour in 51 patients by reading the individual typology angle (ITA°) with a spectrophotometer, followed by the application of the Stigma Scale of the Explanatory Model Interview Catalogue (EMIC).ResultsSkin hyperpigmentation was observed in 100% of the individuals. They showed more negative ITA° values in lesion areas than non‐lesion areas, particularly in sun‐exposed regions. Clofazimine‐induced cutaneous hyperpigmentation was not homogeneous and seemed to follow the lesion locations. The mean EMIC score was 18.8 points.ConclusionAll patients presented skin hyperpigmentation caused by clofazimine, detectable through spectrophotometry. Hyperpigmentation strongly impacted the social domain, indicating the intersectionality of disease and skin colour stigma, contributing to the social isolation of these patients. Health authorities should consider the negative impact of clofazimine on treatment adherence.

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“…Its direct effect leads to ophthalmic complications. Visual impairment and blindness occur in patients with ocular leprosy; these individuals are from a severely disadvantaged group because of other disabilities due to the disease, its social stigma, and the difficulties and delay in receiving appropriate eye care [10]. However, multi-drug therapy reduced the global incidence of leprosy-related eye diseases.…”

Section: Introductionmentioning

confidence: 99%

commerciallyThe magnitude and associated factors of ocular lesions/complications among leprosy patients treated at Boru Meda General Hospital, Ethiopia: Cross-sectional study design, 2021

Bialfew,

Alemu Gelaye,

Ali Dawed

et al. 2023

Ophthalmol J

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BACKGROUND: Leprosy, also known as Hansen's disease, is one of the world's oldest diseases, and it is one of the major blinding diseases. Visual impairment in leprosy patients needs special consideration by dermatologists and ophthalmologists, not only preventable but also has a severe burden that affects productivity if not managed early. Nevertheless, little was understood about ocular complications and associated factors among leprosy patients in low-income countries like Ethiopia, including the study locality. MATERIAL AND METHODS: An institution based cross-sectional study was conducted among a total of 423 leprosy patients at the dermatology clinic at Boru Meda Hospital, Dessie, Ethiopia. The collected data were entered into EpiData v3.1 and exported to the statistical package for SPSS v.20 for statistical analysis. The odds ratio (OR) and a 95% confidence interval (CI) were estimated to measure the strength of the association between dependent and independent variables. p ≤ 0.05 was used to determine the level of statistical significance. RESULT: 419 leprosy patients participated in this study, accounting for a response rate of 99%. The proportion of ocular complications was found to be 69.9% (95% CI: 65.09-73.9). Age 40 years and above [adjusted odds ratio (AOR) = 5.2, 95% CI: 3.14-8.83], presence of leprosy reaction (AOR = 1.92, 95% CI: 1.12-3.24), and leprosy disability grading [grade 1 disability (AOR = 2.9, 95% CI: 1.35-6.33), grade 2 disability (AOR = 3.0,95% CI: 1.36-7.08) ]were associated with the presence of ocular complication among leprosy patients. CONCLUSION: Our finding showed that the ocular complication/lesion magnitude was high. Age 40 and above, the presence of leprea reaction and disability were significant factors associated with developing ocular complications among leprosy patients. Our results emphasize the need for solid collaboration efforts and commitment to handling ophthalmologic complications among leprosy patients aged 40 and above with leprosy reactions and disabilities.

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Perspectives on the impact of stigma in leprosy: strategies to improve access to health care

Cited by 6 publications

References 42 publications

Perceived Stigma as a Risk Factor for Delay in Seeking Treatment of Leprosy Patients: A Cross-Sectional Study in Tuban Regency

Perceived Stigma as a Risk Factor for Delay in Seeking Treatment of Leprosy Patients: A Cross-Sectional Study in Tuban Regency

Clofazimine‐induced cutaneous hyperpigmentation as a source of stigma in the treatment of leprosy: A cross‐sectional study

commerciallyThe magnitude and associated factors of ocular lesions/complications among leprosy patients treated at Boru Meda General Hospital, Ethiopia: Cross-sectional study design, 2021

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