NLR, Amsterdam, Netherlands.
Erasmus University Medical Center Rotterdam, Rotterdam, Netherlands.
PLoS Negl Trop Dis. 2019 Apr 5;13(4):e0007302. doi: 10.1371/journal.pntd.0007302. eCollection 2019 Apr.
With the introduction of new interventions to prevent leprosy, such as post-exposure prophylaxis (PEP) given to contacts of leprosy patients, it is necessary to update our understanding of knowledge and perception of leprosy among the populations where these interventions will be introduced, in order to tailor communication optimally to the current situation. This study is a baseline study of the PEP++ project and aimed to assess the knowledge, attitudes and practices regarding leprosy in Fatehpur, India.
The study used a community-based cross-sectional design with a mixed-methods approach. We assessed knowledge, attitudes, and practices with the KAP measure, and stigma with the Explanatory Model Interview Catalogue community stigma scale (EMIC-CSS) and the Social Distance Scale (SDS). In addition, semi-structured interviews and focus group discussions were conducted with all participant groups. The quantitative data were analysed using stepwise multivariate regression. The qualitative data were analysed using open, inductive coding and content analysis.
A total of 446 participants were included in the study: 100 persons affected by leprosy, 111 close contacts, 185 community members and 50 health care workers. In addition, 24 in-depth interviews were conducted and 35 people were included in focus group discussions. 12.5% of the participants had adequate knowledge of leprosy, while 22% had poor knowledge. Knowledge on cause (answered correctly by 10% of the participants), mode of transmission (5%) and symptoms of leprosy (16%) was especially poor. The mean EMIC-CSS score was 15.3 (95%CI 14.6-16.0) and mean SDS score 7.2 (95%CI 6.6-7.8). Better knowledge of leprosy was associated with lower levels of social distance towards persons affected by leprosy.
This study revealed poor knowledge regarding leprosy and high levels of stigma and fear and desire to keep social distance towards persons affected by leprosy. Community education that takes cultural beliefs, knowledge gaps and fears into consideration could improve knowledge, reduce misconceptions and positively influence the perception of leprosy.
随着新的麻风病干预措施（如为麻风病患者的接触者提供接触后预防（PEP））的引入，有必要更新我们对这些干预措施引入地区人群中麻风病的知识和认知，以便根据当前情况对传播内容进行优化。本研究是 PEP++项目的基线研究，旨在评估印度法特普尔的麻风病知识、态度和实践情况。
本研究采用基于社区的横断面设计，采用混合方法。我们使用 KAP 量表评估知识、态度和实践，使用解释模型访谈目录社区耻辱量表（EMIC-CSS）和社会距离量表（SDS）评估耻辱感。此外，对所有参与者群体进行了半结构访谈和焦点小组讨论。使用逐步多元回归分析对定量数据进行分析。使用开放式、归纳式编码和内容分析对定性数据进行分析。
共有 446 名参与者参与了这项研究：100 名麻风病患者，111 名密切接触者，185 名社区成员和 50 名卫生保健工作者。此外，进行了 24 次深入访谈，35 人参加了焦点小组讨论。12.5%的参与者对麻风病有足够的了解，而 22%的参与者知识水平较差。对病因（10%的参与者回答正确）、传播途径（5%）和麻风病症状（16%）的了解特别差。EMIC-CSS 平均得分为 15.3（95%CI 14.6-16.0），SDS 平均得分为 7.2（95%CI 6.6-7.8）。麻风病知识水平较高与对麻风病患者的社会距离水平较低有关。
本研究揭示了麻风病知识水平较低，耻辱感和恐惧水平较高，以及对麻风病患者保持社会距离的愿望。考虑到文化信仰、知识差距和恐惧，开展社区教育可以提高知识水平，减少误解，并对麻风病的认知产生积极影响。
