Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies
January 2012
Global Health Action;2012, Vol. 5 Issue 1, p1
Academic Journal
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. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. 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 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent ofPLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. 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.


Related Articles

  • Predictors of oral health after spinal cord injury. Sullivan, A L; Bailey, J H; Stokic, D S // Spinal Cord;Apr2013, Vol. 51 Issue 4, p300 

    Study design:Cross-sectional study.Objectives:To examine predictors of oral health in people with spinal cord injury (SCI).Methods:Ninety-two people with SCI (6 months, 44% cervical level) completed questionnaires and underwent oral examination. Socio-economic, injury-related and oral...

  • Personality and Parenting Processes Associated with Problem Behaviors: A Study of Adolescents in Santiago, Chile. Bares, Cristina B.; Delva, Jorge; Grogan-Kaylor, Andrew; Andrade, Fernando // Social Work Research;Dec2011, Vol. 35 Issue 4, p227 

    Considerable research in the United States has established that adolescent antisocial, aggressive, and attention problem behaviors negatively influence adolescents' ability to become productive members of society. However, little is known about the development of these problems among adolescents...

  • The Role of Social Support and Acculturative Stress in Health-Related Quality of Life Among Day Laborers in Northern San Diego. Salgado, Hugo; Castañeda, Sheila; Talavera, Gregory; Lindsay, Suzanne // Journal of Immigrant & Minority Health;Jun2012, Vol. 14 Issue 3, p379 

    There is evidence to suggest that Latino day laborers experience higher levels of acculturative stress than Latinos in employment sectors in the US. Given the stress-buffering role that social support plays in minimizing the negative physical and mental health outcomes of stress, this study...

  • Predicting falls in elderly receiving home care: The role of malnutrition and impaired mobility. Meijers, Judith; Halfens, R.; Neyens, J.; Luiking, Y.; Verlaan, G.; Schols, J. // Journal of Nutrition, Health & Aging;Jul2012, Vol. 16 Issue 7, p654 

    To investigate the role of malnutrition, impaired mobility and care dependency in predicting fallers in older Dutch home care clients. Design: This study is a secondary analysis of data of the annual independent National Prevalence Measurement of Care Problems of Maastricht University. The...

  • The Prevalence of Pain in Patients Attending Sarcoma Outpatient Clinics. Kuo, P. Y.; Yen, J. T. C.; Parker, G. M.; Chapman, S.; Kandikattu, S.; Sohanpal, I.; Barbachano, Y.; Williams, J. E. // Sarcoma;2011, p1 

    The prevalence of pain in patients with sarcoma is not well documented. We investigated this in outpatients at a tertiary cancer referral centre, assessing the adequacy of pain control and for risk factors leading to higher prevalence and severity of pain. 149 patients were surveyed. Patients...

  • Is Maternal Influenza or Fever During Pregnancy Associated with Autism or Developmental Delays? Results from the CHARGE (CHildhood Autism Risks from Genetics and Environment) Study. Zerbo, Ousseny; Iosif, Ana-Maria; Walker, Cheryl; Ozonoff, Sally; Hansen, Robin; Hertz-Picciotto, Irva // Journal of Autism & Developmental Disorders;Jan2013, Vol. 43 Issue 1, p25 

    We analyzed data from case groups of 538 children with autism spectrum disorders (ASD) and 163 with developmental delays (DD), and from 421 typically developing controls to assess associations with maternal influenza or fever during pregnancy. Exposure information was obtained by telephone...

  • Attitudes and beliefs of Brazilian physical therapists about chronic low back pain: a cross-sectional study. Magalhães, Maurício O.; Costa, Leonardo O. P.; Cabral, Cristina M. N.; Machado, Luciana A. C. // Brazilian Journal of Physical Therapy / Revista Brasileira de Fi;mai/jun2012, Vol. 16 Issue 3, p248 

    Objectives: To measure the attitudes and beliefs of Brazilian physical therapists about chronic low back pain and to identify the sociodemographic characteristics that are more likely to influence these attitudes and beliefs. Methods: We conducted a cross-sectional study with 100 Brazilian...

  • Neuromuscular Scoliosis in Children with Spinal Cord Injury. Mulcahey, M. J.; Gaughan, John P.; Betz, Randal R.; Samdani, Amer E.; Barakat, Nadia; Hunter, Louis N. // Topics in Spinal Cord Injury Rehabilitation;Spring2013, Vol. 19 Issue 2, p96 

    Background: The prevalence of neuromuscular scoliosis in children with spinal cord injury (SCI) is high. Published reports suggest that age at time of injury is the most important determinant. No studies have evaluated neurological characteristics using standardized methods to determine if they...

  • Use of Adult Day Care Centers: Do They Offset Utilization of Health Care Services? Iecovich, Esther; Biderman, Aya // Gerontologist;Feb2013, Vol. 53 Issue 1, p123 

    Purpose: Based on the medical offset effect, the goal of the study was to examine the extent to which users and nonusers of adult day care centers (ADCC) differ in frequency of use of out-patient health services (visits to specialists) and in-patient health services (number of hospital...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics