RESUMEN
Within the Eastern Leprosy Control Project of Nepal, a retrospective case control study looked for simple factors that might be used operationally to predict non-compliant behaviour in patients. Patients with these factors would then become the targets of measures such as intensified health education messages and home visits in order to reduce the risk of defaulting. A study of 1442 patient cards (half defaulters, half treatment completed) revealed occasional small but significant demographic and clinical differences, but none was of a sufficient magnitude to be operationally useful. Review of the attendance of patients in the first few months of treatment suggested that eventual defaulting was strongly associated with irregularity from the commencement of treatment. It is possible that an early indicator based on attendance over the first months can be used to target patients who are in danger of non-completion of treatment.
Asunto(s)
Leprostáticos/uso terapéutico , Lepra/tratamiento farmacológico , Negativa del Paciente al Tratamiento/estadística & datos numéricos , Adolescente , Adulto , Estudios de Casos y Controles , Quimioterapia Combinada , Femenino , Humanos , Incidencia , Lepra/diagnóstico , Masculino , Persona de Mediana Edad , Nepal , Valor Predictivo de las Pruebas , Estudios Retrospectivos , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
This study describes community behaviour towards persons affected by leprosy in the eastern Terai districts of Nepal. The results show that 95% of the persons affected by leprosy recognized by the community have visible signs such as wounds, swellings and deformed feet or hands. Persons affected by leprosy still experience negative behaviour. Motives for negative community behaviour are mostly found in the fact that people fear infection by germs, but fear of a curse from God is also mentioned. This study shows that negative community behaviour is still present in eastern Nepal. Leprosy is more than a disease; the disease can nowadays be medically cured, but the sickness of leprosy still remains. Leprosy control programmes should focus on prevention of impairments and disabilities, because it seems that a visible sign is an important trigger for negative community behaviour.