Patan Academy of Health Sciences, Lalitpur, Nepal.
National Medical College and Teaching Hospital, Tribhuvan University, Birgunj, Parsa, Nepal.
PLoS Negl Trop Dis. 2019 Jan 11;13(1):e0007075. doi: 10.1371/journal.pntd.0007075. eCollection 2019 Jan.
Though Nepal declared leprosy elimination in 2010, its burden is constantly rising in Terai communities for the past 2 years with 3000 new leprosy cases being diagnosed annually. Community's perception is important for prevention and control of leprosy and enhancing quality of life of leprosy patients. Poor knowledge, unfavorable attitude and stigma create a hindrance to leprosy control. The main objective of this study was to assess the knowledge, attitude and stigma of leprosy amongst the community members living in Dhanusha and Parsa districts of Southern Central Nepal.
A total of 423 individuals were interviewed using a structured questionnaire in Dhanusha and Parsa districts. Data was analyzed using both descriptive (frequency, percentage, median) and statistical inferences (Chi-square test, Kruskal Wallis H test, Mann Whitney U test, binary logistic regression) using SPSSvs20.
All respondents had heard about leprosy. Source of information on leprosy was mainly found to be health workers/hospitals (33.1%). Only 62.6% reported bacteria being its cause followed by other myths such as bad blood/curse/heredity/bad deeds (36%). Only 43.8% responded that leprosy is transmitted by prolonged close contact with leprosy patients and 25.7% reported religious rituals as the treatment. Only 42.1% had good knowledge and 40.9% had favorable attitude. Good knowledge of leprosy was highly associated with favorable attitude towards leprosy (P<0.001). The outcome variables- knowledge, attitude and EMIC score were found to have highly significant association with age, sex, ethnicity, religion, education and occupation of the respondents (P<0.001). Having knowledge on leprosy transmission was positively associated with favorable attitude towards leprosy (P<0.001).
Strategizing the awareness programmes according to socio-demographic characteristics for enhancing the knowledge regarding leprosy cause, symptoms, transmission, prevention and treatment, can foster the positive community attitude towards leprosy affected persons. Enhancing positive attitude towards leprosy affected persons can reduce the community stigma, thus may increase their participation in the community. Positive attitude may further increase their early health seeking behaviour including their quality of life.
尽管尼泊尔在 2010 年宣布消灭了麻风病，但在过去的两年中，特莱地区的社区麻风病负担不断增加，每年诊断出 3000 例新的麻风病病例。社区的认知对于麻风病的预防和控制以及提高麻风病患者的生活质量非常重要。知识匮乏、态度不佳和污名化会阻碍麻风病的控制。本研究的主要目的是评估生活在尼泊尔南部中央的达努沙和帕尔萨地区的社区成员对麻风病的知识、态度和耻辱感。
在达努沙和帕尔萨地区，共有 423 人接受了结构化问卷的访谈。使用 SPSSvs20 采用描述性（频率、百分比、中位数）和统计推断（卡方检验、克鲁斯卡尔-沃利斯 H 检验、曼-惠特尼 U 检验、二元逻辑回归）对数据进行分析。
所有受访者都听说过麻风病。麻风病信息的主要来源是卫生工作者/医院（33.1%）。只有 62.6%的人报告细菌是其病因，而其他神话，如坏血/诅咒/遗传/不良行为（36%）。只有 43.8%的人回答说麻风病是通过与麻风病患者长时间密切接触传播的，25.7%的人报告说宗教仪式是治疗方法。只有 42.1%的人具有良好的知识，40.9%的人具有良好的态度。良好的麻风病知识与对麻风病的良好态度高度相关（P<0.001）。知识、态度和 EMIC 评分这三个结果变量与受访者的年龄、性别、种族、宗教、教育和职业高度相关（P<0.001）。对麻风病传播知识的了解与对麻风病的良好态度呈正相关（P<0.001）。
根据社会人口特征制定宣传计划，以提高对麻风病病因、症状、传播、预防和治疗的认识，可以培养社区对麻风病患者的积极态度。对麻风病患者的积极态度可以减少社区的耻辱感，从而增加他们的社区参与度。积极的态度可能会进一步提高他们的早期健康寻求行为，包括他们的生活质量。
