[Activity of daily living and life quality of patients with Hansen's disease in Taiwan].

BACKGROUND: Hansen's Disease incidence in Taiwan has declined to the goal set by the World Health Organization. However, this population does not receive adequate attention due to the stigma attached to the disease. PURPOSE: The purpose of this study was to investigate the demographic characteristics, activities of daily living, and quality of life of patients with Hansen's Disease in Taiwan. METHODS: A cross-sectional design was used. A structured questionnaire that incorporated a personal data survey form, basic activity of daily living (BADL) form, instrument ability of daily activity of living (IADL) form and quality of life (QOL) survey was used to collect data. Patients with Hansen's Disease in Taiwan who lived in the institution, rural villages, and communities were invited to participate. RESULTS: Four hundred and ninety-seven participants with an average age of 71.93 (± 12.8) years participated in this study. Institutionalized participants (76.97 ± 7.41) were older than those in the other two groups. Participants were found to have in general more than one chronic disease (2.05 ± 1.33), with more chronic diseases found amongst institutionalized subjects (2.70 ± 1.23). Activities of daily living scores were generally higher for urban community dwellers than those who were institutionalized. Relatively low BADL scores for personal hygiene, bathing, walking and climbing stairs were noted, as were poor IADL scores for cooking, shopping, washing clothes and riding public transportation. Results found that activities of daily living declined with participant age (p < .001). The QOL score was mid-range, while the mental dimension of QOL was poorer than the physical dimension. Higher QOLs were observed in participants who lived in villages, while poorer QOLs were observed in participants who lived in communities. CONCLUSIONS: The results of this study indicated activities of daily living scores declined among Hansen's Disease patients with age. In order to promote quality of life among patients with Hansen's Disease, several suggestions for health policy with regard to Hansen's Disease patients are raised in this paper, including helping maintain daily living activity functions in Hansen's Disease patients, hiring more assistants and nurses to help Hansen's Disease patients maintain daily living activities and personal hygiene, and enhancing living environment quality and medical service appropriateness.

Association of HLA-DRB1*0405 with resistance to multibacillary leprosy in Taiwanese.

Host factors play an important role in determining the immune response and development of leprosy. The human leukocyte antigen system (HLA) has repeatedly been found to be associated with the pathogenesis of leprosy. This study analyzes the polymorphism of the HLA class I and II antigens in multibacillary leprosy patients and a healthy control group to provide predictable prognostic indicators and/or a differential diagnostic for the disease. Sixty-5 multibacillary leprosy patients from Lo-Sheng Leprosarium and 190 healthy Taiwanese were used as cases and controls, respectively. A serologic method was initially used for HLA-A and HLA-B antigen determination, and sequence-based typing was later applied for HLA-DRB1 allele typing. Although no significant associations were found with HLA-A or HLA-B antigens, this study shows a strong HLA-DRB1*0405 association with resistance to multibacillary leprosy, supporting results previously reported in the literatures.