Comparing the perception of community members towards leprosy and tuberculosis stigmatization.

BACKGROUND: Health professionals at all levels gradually recognise the impact of stigma on case detection and treatment of various health conditions such as leprosy and tuberculosis. These diseases are identified as chronic diseases which are prone to stigmatisation. PURPOSE: To assess the perception of community members towards stigma related to leprosy and tuberculosis, in order to verify and compare the existence of stigma towards these two diseases in the community, and to provide baseline data for the evaluation of future de-stigmatising interventions. METHODS: This study was done in four sub-districts of Chaiyaphum province. Community members were interviewed using the EMIC stigma scale. Frequency was used to identify the percentage of community members who perceived stigma. A T-test was applied to compare the mean EMIC scores of community members between leprosy and tuberculosis. A P-value of < 0.05 was considered indicative of a statistically significant difference or association. RESULTS: It was found that community members perceived that people affected by leprosy or tuberculosis were stigmatised by the community. However, community members perceived more stigma towards leprosy than towards tuberculosis, particularly in terms of shame, embarrassment, and problems in getting married. The difference was highly significant (P = 0.001, paired t-test). CONCLUSION: The community's perceived stigma against people affected by either leprosy or tuberculosis may affect many aspects of their lives. The authors recommend use of strategically targeted de-stigmatising interventions that take local attitudes and perceptions into consideration.

How to reduce stigma in leprosy--a systematic literature review.

BACKGROUND: Interventions to reduce leprosy-related stigma reduce the manifestations of stigma that cause so much suffering to individuals and their families. PURPOSE: This systematic review aims to identify interventions that have been used to reduce such stigma and to summarise what is known about their efficacy. METHOD: Electronic searches were undertaken using PubMed (Medline), CINAHL and PsycInfo databases. The internet was searched using Google Scholar for papers not published in these databases. All relevant papers written in Thai or English were included. RESULTS: After reading 55 papers, three duplications and parallel literatures were removed, 18 were removed on abstract screening and nine after reading the full papers; eventually, 25 were included in this review. Interventions with some evidence of effectiveness in terms of stigma reduction comprise the integration of leprosy programmes into general health care; Information Education and Communication (IEC) programmes; and socio-economic rehabilitation. CONCLUSION: More evaluations are needed of the effect of the integration of leprosy programmes into general health services. The design and implementation of IEC interventions need to be preceded by careful study of the target area and population and should be undertaken in combination with other activities.

El estigma en la lepra: conceptos, causas y determinantes / No disponible

Antecedentes: La lepra es una enfermedad infecciosa crónica que ha estigmatizado a los afectados desde la antigüedad hasta nuestros días. Objetivo: Se llevó a cabo esta revisión para entender el concepto, la causa y los determinantes del estigma de la lepra. Métodos: Se realizaron búsquedas electrónicas empleando PubMed (Medline) y las bases de datos CINAHL y Psyclnfo. Se buscaron trabajos no incluidos en estas bases de datos mediante Google Académico. El principal criterio para la inclusión fue el de trabajos relacionados con el estigma o lepra escritos en Thai o inglés. Resultados: Después de las búsquedas se identificaron 84 trabajos, 3 fueron eliminados por duplicidad y publicación paralela y 20 se eliminaron al revisar el resumen. Después de revisar 61 trabajos, se excluyeron 7. Por tanto, se incluyeron 54 trabajos en esta revisión. Se halló que el concepto de estigma implica no solamente características consideradas poco deseables, sino también el contexto social del individuo o grupo afectado. Las causas y determinantes del estigma relacionados con la lepra son las manifestaciones visibles de la enfermedad, las creencias culturales o religiosas, el miedo a la transmisión, la asociación con personas consideradas inferiores o intervenciones públicas relacionadas con la sanidad. Conclusión: El estigma es un fenómeno complejo que tiene múltiples causas, muchas veces relacionadas con el contexto cultural en que se presenta. A pesar de esto, se encontraron muchas similitudes con el estigma relacionado con la lepra en distintos países y culturas, que facilitaron el desarrollo de las intervenciones y el estudio

Background: Leprosy is a chronic infectious disease that has stigmatised people affected since ancient times until now. This has resulted in difficulties in the lives of those affected. Purpose: this literature review was conducted to understand the concept, causes, and determinants of stigma in leprosy. Methods: electronic searches were undertaken using PubMed (Medline), CINAHL and Psyclinfo databases. The internet was searched through Google Scholar for papers not found in these databases. The main inclusion criteria were papers related to stigma or leprosy written in Thai or English. Results: After searching the databases, 84 papers were identified, 3 were removed because of duplication and parallel publication, and 20 were removed on abstract screening. After reading 61 full papers, 7 were excluded. Finally, 54 were included in this review. It was found that the concept of stigma involves not only characteristics considered undesirable, but also the social context of the individual or group. Reported causes and determinants of stigma related to leprosy are the external manifestations of the disease, cultural and religious beliefs, fear of transmission, association with people considered inferior and public health-related interventions. Conclusion: Stigma is a complex phenomenon that has multiple causes, often linked to the cultural context in which it occurs. Despite this, many similarities were found in leprosy-related stigma across countries and cultures, which would facilitate the development of interventions

Stigma in leprosy: concepts, causes and determinants.

BACKGROUND: Leprosy is a chronic infectious disease that has stigmatised people affected since ancient times until now. This has resulted in difficulties in the lives of those affected. PURPOSE: This literature review was conducted to understand the concept, causes, and determinants of stigma in leprosy. METHOD: Electronic searches were undertaken using PubMed (Medline), CINAHL and PsycInfo databases. The internet was searched through Google Scholar for papers not found in these databases. The main inclusion criteria were papers related to stigma or leprosy written in Thai or English. RESULTS: After searching the databases, 84 papers were identified, 3 were removed because of duplication and parallel publication, and 20 were removed on abstract screening. After reading 61 full papers, 7 were excluded. Finally, 54 were included in this review. It was found that the concept of stigma involves not only characteristics considered undesirable, but also the social context of the individual or group. Reported causes and determinants of stigma related to leprosy are the external manifestations of the disease, cultural and religious beliefs, fear of transmission, association with people considered inferior and public health-related interventions. CONCLUSION: Stigma is a complex phenomenon that has multiple causes, often linked to the cultural context in which it occurs. Despite this, many similarities were found in leprosy-related stigma across countries and cultures, which would facilitate the development of interventions.