Volume - 81, Issue - 2
‘Environmental’ sources of
Mycobacterium leprae : Issues and evidence- Richard Truman
- Paul E. M. Fine
Volume 81, Issue 2| Published on June 2010
A
Mycobacterium leprae VNTR database- Barry G. Hall
Volume 81, Issue 2| Published on June 2010
‘Money is the vehicle of interaction’: Insight into social integration of people affected by leprosy in Northern Nigeria
- Bassey Ebenso
- Mainas Ayuba
Volume 81, Issue 2| Published on June 2010
Objective: This paper proposes a mechanism by which socio-economic rehabilitation (SER) reduces stigma in northern Nigeria following a re-analysis of the transcripts of interviews conducted to evaluate the impact of SER on leprosy-related stigma.
Design: The evaluation combined quantitative questionnaire (P-scale) with qualitative interviews of 20 individuals affected by leprosy, five focus group discussions and 10 key informant interviews. From our data, we developed a leprosyrelated stigma framework by integrating emerging themes with the construct of threat to group functioning to describe stigma processes experienced by people affected by leprosy in northern Nigeria.
Results: Findings revealed people affected by leprosy are less likely to be stigmatised because of leprosy impairments than for their incapacity to contribute to family/community finances. We also identified micro-credit loans and vocational training as elements of SER for reducing stigma through the mechanism of protecting individuals against the loss of social value, and by facilitating their continued engagement in daily social roles in the family/community.
Conclusion: We propose that SER stimulates attitudinal change towards, and inclusion of people affected by leprosy by protecting individuals against the loss of social value and increasing their contributive capacity. We recommend further empirical testing of the proposed framework to ascertain its utility in other cultures.
Impacts of the diagnosis of leprosy and of visible impairments amongst people affected by leprosy in Cebu, the Philippines
- Noriko Boku
- Diana N. J. Lockwood
- Maria Victoria Balagon
- Fe Eleanor F. Pardillo
- Armi A. Maghanoy
- Irene B. Mallari
- Hugh Cross
Volume 81, Issue 2| Published on June 2010
Purpose: To quantify the impact of the diagnosis of leprosy and of visible impairments in people affected by leprosy.
Subjects and Methods: Three interview-based questionnaires designed to measure activity limitation, participation restriction, and general self-efficacy were used to collect data from three Groups. Group 1: leprosy affected people with visible impairment, Group 2: newly diagnosed leprosy patients with no visible impairment, Group 3: patients with other skin diseases symptomatic for more than 1 month.
Results: One hundred and eight subjects were recruited. The subjects with visible impairments (Group 1) had higher levels of participation restriction than those with skin disease (P0.012), and participation restriction was similar between subjects in Groups 2 and 3 (P0.305). The people in Group 1 (35 subjects) also reported significantly more activity limitation compared to the people in either Group 2 (35 subjects) or Group 3 (38 subjects) (P 0.001, respectively). The subjects in Group 2 had no significant activity limitation compared with those in Group 3 (P0.338). A multivariate analysis showed that severe visible impairment was a risk factor for activity limitation (odds ratio 5.68, 95% CI: 1.09–29.7, P0.039) and a low level of self-efficacy (Odds ratio 6.38, 95% CI: 1.06–38.3, P0.043) among people affected by leprosy.
Conclusion: Visible impairments affected the activities and attitudes of people affected by leprosy. However, others without visible impairment, had activity limitations, participation restrictions and levels of general self-efficacy that were similar to patients with other skin diseases. Prevention of visible impairments should be considered a key intervention for stigma reduction.
Integration of leprosy in general health system vis-à-vis leprosy endemicity, health situation and socioeconomic development: observations from Chhattisgarh & Kerala
- Aparna Pandey
- Harish Rathod
Volume 81, Issue 2| Published on June 2010
This study looked at the integration of leprosy services in the GHS in context of health and socioeconomic situations using predefined indicators. It also looked at clients perception of MDT services. The Indian states of Chhattisgarh and Kerala, which are at two extremes in leprosy endemicity, health situation and socioeconomic development, have been compared using predefined integration indicators related to the training of health workers, availability of MDT services, maintenance of MDT stock and involvement of Sub-centres in leprosy care. Data was collected by surveys of health facilities, sub-centres and communities in the two states, during 2006–2007. Information was collected by interviewing health personnel and clients, checking of records and on the spot observations using specifically designed formats. Results showed that integration is more inclusive in Chhattisgarh and has reached up to Sub-centre level. Both the community and health systems are sensitive and responsive to leprosy as it is perceived to be a major public health threat. But in Kerala, despite integration, it continues as a vertical programme with dependence on specialists and districts hospitals for diagnosis and treatment. MDT stock management is even poorer. Clients perception towards MDT services are similar in both states.