Karma in popular Hindusim. Delay in presentation and start of treatment in leprosy patients: A case-control study of disabled and non disabled patients in three different settings in Ethiopia. Int J Lepr;
Kesumaningsih Find articles by Kadek I. This article has been cited by other articles in PMC. Abstract Background Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries.
Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment.
Methods We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health.
Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Results Overall 1, persons with leprosy-related disability PLD and community members were included.
Seventy-seven percent of PLD had physical impairments. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems.
Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. Discussion The majority of respondents reported problems in all components of disability.
The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention. Stigma was a major determinant of social participation, and therefore disability.
Stigma reduction activities and socio-economic rehabilitation are urgently needed in addition to strategies to reduce the development of further physical impairment after release from treatment.
Disability is a difficulty in functioning at the body, person, or societal levels, in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors 2. The classification also recognizes the role of physical and social environmental factors in affecting disability outcomes.
Leprosy is an important cause of preventable disability 4. Physical impairment associated with leprosy is usually secondary to nerve damage resulting from the chronic granulomatous inflammation due to Mycobacterium leprae 5.
Impairments may give rise to disabilities, such as limitations of activities involving the use of hands, feet and eyes, and restrictions in social participation.
Grade 0 — no impairment, Grade 1 — loss of sensation in the hand or foot, and Grade 2 — visible impairment 6. Multi-drug treatment MDT can cure leprosy, and, if instituted early, can prevent disability. However, leprosy is still often diagnosed too late, when permanent impairment has already occurred.
Even after completion of treatment, a significant proportion of patients sustain disability from nerve damage, requiring continued self- care to limit further secondary damage 5. Future projections of the global leprosy burden show that 5 million new cases would arise between andand that in there would be an estimated 1 million people with WHO grade 2 disability 7.
There is very little data on the types of problems faced by people with leprosy-related disabilities PLD and the resulting needs they have for services 5. Though much progress has been made in reducing the number of leprosy patients registered for MDT globally, relatively little is known about disability after release from treatment.
Therefore there is an urgent need for data on leprosy-related disability to assess the need for prevention of disabilities POD and rehabilitation services.
Such data are also needed for programme monitoring, evaluation and for advocacy 8. In addition to physical impairments and activity restrictions, PLD are likely to suffer from social stigma and discrimination leading to economic loss 9. Stigma is not a single phenomenon, but consists of several possible components, e.
The different aspects of health-related stigma can be measured using questionnaires, qualitative methods, indicators and scales Similarly, suitable ICF-based instruments now exist to assess different aspects of disability and the factors contributing to these 5.
Indonesia ranks third in the number of new leprosy cases after India and Brazil We conducted a cross-sectional baseline survey in five leprosy-endemic districts in Indonesia. Our aim was to assess the extent of disability and its determinants among persons with leprosy-related disabilities after release from MDT.
In particular, we examined the incidence of worsening of physical impairment after release from treatment, the impairment in carrying out daily activities activity restrictionssocial participation, stigma anticipated and discrimination, all within the conceptual framework of the ICF.
Methods Design and sampling We conducted a cross-sectional house-to-house survey amongst persons affected by leprosy in five districts in Indonesia: Eligible were persons with any leprosy-related impairments, activity limitations or participation restrictions who had been released from MDT up to 5 years earlier.
We obtained lists from the district cohort registers of all people affected by leprosy who had completed and been released from treatment in the past 5 years. Local health workers tried to contact as many of these as they could trace. The persons contacted were asked for consent to be screened for disability by leprosy-specialised health workers using a short eight-question questionnaire see Appendix 2.
Furthermore, participants were excluded if they had mental impairment, severe hearing or speaking problems or were aged less than 10 years.Understanding Causes and Overcoming Injustices.
Edited by Patrick W. Corrigan. â The pernicious effects of stigma are general and specific. grupobittia.com is a (c)3 non-profit organization.
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In other words, leprosy eradication requires the changing social perception of leprosy; by recognizing leprosy as just another curable illness, social stigma can be eliminated, thereby increasing chances of early reporting and cure. Colonial and religious influence and associated stigma continued to be a major factor in the treatment and public perception of leprosy in endemic developing countries until the mid-twentieth century.
Abstract. This paper explores how iatrogenic stigma, or stigma that is produced through a patient's encounter with physicians or with biomedicine in general, might emerge in outpatient treatment for Hansen's disease, or leprosy.
The experience of disease is not limited to the effects any bacteria, virus, or parasite has on the body. The way in which communities interact with diseased bodies impacts the experience of the disease. Often, the greatest burden comes from how diseased bodies are conceptualized within society.