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editorial
Page 1
Editorial
Pages 2 - 11
Original Papers
Pages 12 - 25
  • Factors influencing the mental wellbeing of persons affected by leprosy in Far-Western Nepal

    • Louise Pierneef
    • Anna T. van ’t Noordende
    • Mamta Bista
    • Usha Singh
    • Manon B. Scheltema
    • Ashok K. Joshi
    • Mukesh Pant
    • Labhi Shakya
    • Mitzi M. Waltz
    • Wim H. van Brakel
    Volume 93, Issue 1

    | Published on March 2022

    Objective

    To investigate factors that influence the mental wellbeing of persons affected by leprosy in Far-Western Nepal.

    Methods

    The study used a cross-sectional design with a qualitative approach. Semi-structured, in-depth interviews and focus group discussions covering topics such as feelings towards and experiences with leprosy, mental wellbeing, knowledge about leprosy, social life, community, culture and future outlook were employed. The data were analysed using Framework Analysis and Thematic Open Analysis.

    Results

    A total of 25 persons affected by leprosy were included in the in-depth interviews and 13 persons participated in focus group discussions. We found that participants often experienced stigma and/or mental distress. Participants reported physical weakness or pain, activity limitations, worries about their disease and its implications, feelings of shame, suicidal thoughts, and perceived and/or internalised stigma. Factors influencing mental wellbeing included discrimination, social support, religion, participation (restrictions), (in)ability to work, community attitudes, knowledge of leprosy and cultural beliefs about the disease.

    Conclusions

    This study revealed that the majority of participants faced leprosy-related stigma, physical discomfort, restrictions in social participation and mental distress. We recommend the development of interventions such as counselling after diagnosis with leprosy, increasing leprosy awareness and knowledge, addressing negative attitudes and beliefs in the community and stimulating social participation.

research article
Pages 26 - 37
  • Knowledge and attitudes on leprosy of healthcare workers in a tertiary government hospital in the Philippines

    • Czarina P. Chavez
    • Miyahra Haniko P. Lopez
    • Christine E. de Guia
    • Martha Joy B. Tapales
    • Abelaine A. Venida-Tablizo
    Volume 93, Issue 1

    | Published on March 2022

    Background/Objectives

    The drivers of stigma may vary from one society or country to another; thus, it is necessary to identify these drivers so that stigma elimination programs would be locally relevant. This study aimed to determine the current knowledge and attitudes on leprosy of healthcare workers in a tertiary government hospital in the Philippines which will serve as the basis for our future leprosy awareness campaigns.

    Methods

    We conducted a descriptive cross-sectional study among 265 healthcare workers in Rizal Medical Center (RMC), Philippines from January to March 2020 using a self-administered questionnaire. Descriptive statistics were used to describe the demographics and study variables.

    Results

    A majority had high (36.2%) or medium (35.5%) knowledge on leprosy. A majority (62.3%) had positive attitudes towards leprosy. However, only 18.5% knew that leprosy is transmitted through inhalation and a majority thought that it is transmitted either through body fluids and secretions (52.8%) or open wounds (27.5%). Only about half knew that a patient on treatment can no longer transmit the disease and does not need to be isolated, and that a patient who has completed treatment but still exhibits manifestations of the disease can no longer transmit the disease.

    Conclusion

    Although a majority had either high or medium knowledge on leprosy and a positive attitude towards leprosy, we identified misconceptions and knowledge gaps centered on its mode of transmission and transmissibility which can lead to inappropriate fear of acquiring the disease from patients.

Original Papers
Pages 38 - 47
  • The need for an integrated, contextual, and holistic, minimum essential data collection tool for leprosy and lymphatic filariasis disability in India

    • Shyamala Anand
    • Annamma John
    • Rajni Kant Singh
    Volume 93, Issue 1

    | Published on March 2022

    Aim

    To develop an integrated, contextual, and holistic, minimum essential data collection tool to reliably assess, and obtain a broad overview of issues needing attention among people suffering with WHO Grade 2 leprosy disability and WHO Grade 3 and above lymphatic filariasis (LF) disability in India, to enable the design of integrated and customized interventions to improve their situations.

    Process

    A review of universal tools measuring activity limitations, stigma, participation restrictions, mental wellbeing, quality of life, and community stigma, was carried out for their applicability to leprosy and LF disability. A focus group discussion was conducted with field staff who had used these tools, to learn from their experiences. Questions for the minimum essential data tool were formulated based on their applicability and relevance to people with severe leprosy and LF disabilities, their context, and to our aim.

    Results

    A hybrid quantitative and qualitative minimum essential data tool was developed, integrating leprosy and LF disability related issues to holistically assess situations, capture lived experiences, and enable participation of persons with leprosy and LF disability in designing solutions for the issues which impact them most.

    Conclusions

    Integrated approaches are cost-effective and efficient when customized for the local context and the people impacted. Our tool will be piloted in Bihar, India to assess its reliability in the estimation of needs, and its effectiveness in designing interventions using a person-centered approach, to improve situations for people living with leprosy and LF disability within the cultural and environmental context of rural India.

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