Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the absence of evidence in the literature on cost factors in the management of leprosy, a reference is made to the sporadic attempts to study costs of case detection and treatment. Such studies indicate that in the currently declining phase of leprosy endemicity, employing a conventionally trained, salaried class of paramedical staff for field surveys is prohibitively expensive if cost per case detected is computed. Involving primary healthcare and community derived workers is cost effective. Likewise, short course chemotherapy with newer drugs under trial, administered under supervision by community volunteers, reduces the expenses considerably. Community-based disability services using inexpensive tools may cut costs by 90%. Operational research on cost effectiveness of rehabilitation comparing 'integrated' with 'vertical' approaches is, unfortunately, still in a primitive stage. It is urged that in view of the changing logistics, manpower costs and financial implications should be given serious consideration by health planners. Post-elimination problems such as: (i) unearthing hidden cases; (ii) community-based supervised treatment with highly promising newer drugs; (iii) identification of reactions and relapses; and (iv) field management of disabilities resulting from acute and silent neuritis etc could be solved in a much cheaper manner. Integration of leprosy into general healthcare services and community-based rehabilitation of leprosy patients along with those disabled by other diseases will be the major task in future as these procedures are expected to reduce management costs and eliminate stigma.
 ...
PMID:Socioeconomics of a global leprosy eradication programme. 1017 3

1. Equal rights and opportunities for people affected with leprosy to develop their full potentials is a matter of human rights. 2. Leprosy and its consequences are a complex human problem leading to discriminations, stigma and prejudices. 3. There is lack of complete understanding about global needs for rehabilitation. 4. Concentration on medical care of people affected with leprosy (MDT, surgery, etc.), though vastly beneficial, has led to highly inadequate psycho-socio-economic rehabilitation in a holistic manner resulting in poor quality of life. 5. People affected with leprosy have not been full partners and decision makers for their own development and lack self-confidence and opportunities for self-expression. 6. Community and health providers lack the right attitude and sensitivity, thus failing to assist in the empowerment of people affected with leprosy in an integrated manner. 8. There is insufficient coordination at international/NGOs/government levels to utilize scarce resources to allow full development of people affected with leprosy.
 ...
PMID:Social aspects and rehabilitation. International Leprosy Congress, Beijing, 7-12 September 1998. Workshop report. 1040 52

A case of reconstructive surgery for saddle nose deformity is presented in this paper. A 22 year-old Bengali female who had completed WHO/MB regimen for 27 months underwent reconstructive surgery for saddle nose deformity. Since a saddle nose is one of the symbols of leprosy, it often causes serious psychological and social troubles to patients. This happens more often when the patient is a young unmarried woman. In this case the saddle nose seemed to be very serious. After being discharged from hospital she got married and had a baby. This operation gave the patient great relief to live in the community, because she no longer had serious visible evidence of leprosy on the body. Though the correction of the deformity without any dysfunction does not always have priority over other surgeries at a busy leprosy control project in Bangladesh, it has merit both in patients themselves and in the society around them because it leads to the elimination of the stigma of leprosy.
 ...
PMID:A case of reconstruction of saddle nose deformity in leprosy. 1065 16

Students of leprosy stigma are at odds over its sources, intensity, and current presistence. On the basis of a study of leprosy in Thailand that combined an archival survey with anthropological field-work, the present article offers a different thesis on these issues from those that have been proposed thus far. The thesis suggests that prior to the discovery of a cure for the disease, its sufferers encountered ambivalent rather than severly stigmatizing reactions. Yet the public's selective exposure-mainly to beggars with the disease-paved the way to the perception of leprosy as the epitome of stigmatization and to its transformation into a metaphor for degradation. Progress in the medical treatment of the disease significantly improved patients' social acceptance but also allowed them to keep their illness a secret. Their consequent disappearance from the public eye turned the figurative use of leprosy in the spoken language into the main source of shaping its image. This development contributed to the irrefutability and perpetuation of the negative image, and even to its intensification to the extent of utter divorce from concrete reality. After expounding this thesis, the paper discusses its potential contribution to resolving the disputes over the roots, severity, and persistence of leprosy stigma on the international level.
 ...
PMID:Beggars, metaphors, and stigma: a missing link in the social history of leprosy. 1162 Jan 56

The relationship between psychiatric morbidity in 30 leprosy patients under treatment as assessed by the General Health Questionnaire (GHQ-12) and certain variables of their illness and psychosocial factors is examined in this paper. Physical disability and duration of illness were the illness variables considered; knowledge and adjustment were the psychosocial variables included. Bell's Adjustment Inventory (BAI) measured the latter, psychiatric morbidity was positively correlated with physical disability (p < 0.05), knowledge about the disease (p < 0.01) and social, emotional and health maladjustment (p < 0.01), but not with duration of illness (p > 0.05). The importance of appropriate knowledge, social stigma and physical disability in leprosy is discussed in addressing the psychiatric morbidity of leprosy patients.
 ...
PMID:Correlates of psychiatric morbidity in patients with leprosy. 1184 May 94

Social and cultural factors influencing knowledge, attitudes and practices (KAP) towards leprosy in two communities in eastern Sudan were studied to determine their effects on treatment seeking and compliance. The study was qualitative using focus small group discussions, personal interviews and direct observation. The target populations were Masalit and Hawsa, the two main tribes in the area. Knowledge about the pathological cause of leprosy was lacking but the clinical manifestations were well recognized, particularly among the Masalit, in whom the disease in more common than the Hawsa. Among the Masalit there was a widely held belief that leprosy was caused by eating meat of the wild pig and a certain type of fish. The Hawsa, who are more devout Muslims, do not eat pig and associate leprosy with consumption of two types of fish. Between both tribes, the stigma of leprosy was not strong and the degree of rejection was more towards those with severe disease, particularly patients with ulcerated lesions and severe deformities. Patients were cared for by the family and lived in a separate hut within the families' housing compounds. In this remote area where medical services are scarce or nonexistent, those interviewed did not realize that leprosy was treatable by modern medicine. This influenced the treatment-seeking behaviour of patients, who were often treated by spiritual healers and other traditional medicine practices. With the introduction of multidrug therapy and health education of patients and society, many more patients are now seeking medical treatment, indicating a change in health seeking behaviour.
 ...
PMID:Socio-cultural aspects of leprosy among the Masalit and Hawsa tribes in the Sudan. 1196 23

Integration of leprosy into the general health system is very much emphasized by health care planners. One prime reason stated for this is to reduce stigma attached to this disease. This study was conducted in the state of Maharashtra, India, to compare the level of social stigma towards leprosy in communities with a vertical and an integrated programme. The data were collected in three areas of five villages each. The first two areas were in an integrated programme to test for internal consistency and the third in a vertical programme. All the leprosy patients with visible deformities in these villages were enrolled in the study, and an in-depth stigma measurement scale was administered. In addition, focus group discussions were conducted among the family members of leprosy patients and participative rural appraisal was done in the communities. The data were analysed using qualitative methods. A total of 24 leprosy patients with visible deformities participated in the in-depth stigma measurement exercise from 15 villages. Fifteen focus group discussions were conducted with families of leprosy patients and an equal number of participatory rural appraisals with communities were done. The results show that social stigma was virtually non-existent among the communities with the integrated approach and minimally experienced by leprosy patients in this model. However, a high level of self-stigmatization among leprosy patients was observed in the vertical approach and equally a high level of social stigma was found in their communities, which led to reduced interaction between the leprosy patients and their communities. The integrated approach to community-based primary health care is effective in reducing leprosy stigma in society.
 ...
PMID:Social stigma: a comparative qualitative study of integrated and vertical care approaches to leprosy. 1219 75

This article considers the issues surrounding leprosy, and focuses on the social stigma and mistreatment associated with the disease. In particular, the history of leprosy patients and leprosy-prevention law in Japan is examined in both a historical and social context. Matters related to infringement of human rights are also considered along with issues for nurses caring for patients with leprosy. Eugenics and its legal approval are then discussed, as is the abolition of the leprosy laws in Japan. Finally, the author argues that problems surrounding this infectious disease are not country-specific; nurses may be ignorant of the number of patients with this debilitating disease worldwide, and of the policies and laws surrounding it.
 ...
PMID:Leprosy prevention law and healthcare professionals in Japan. 1224 3

This article provides a discussion of deficiencies in the data collection on disabilities in Pakistan, identifies data sources, and makes recommendations for improving the quality of the data. Major trends in disabilities are identified. In Pakistan, there is social stigma attached to persons with disabilities. Disabilities are concealed within families so as not to limit the marriage prospects of relatives who might otherwise be suspected of carrying defective genes. Religion perpetuates superstitions about the disabled. Families bear an extra expense in caring for a disabled member, due to loss of additional labor, increased demands on resources for taking care of the disabled member, and increased need to compensate with higher fertility. There is a lack of social institutional support for care of the disabled. The population censuses of 1961 and 1981 were the first to collect information on the disabled. The inadequacy of census data led to the initiation of a national survey in 1984/85 for collecting data on blindness, deafness, mutism, leprosy, retardation, lameness, and handicaps. A special in-depth survey on disabilities was also conducted in Islamabad and Rawalpindi districts in 1986. This survey focused on mental retardation, visual and hearing disabilities, deformity and wasting of the limbs, and physical disabilities, such as paralysis. This survey was the most valid but it was not comparable to prior surveys. Trends indicate a smaller number of disabled at older ages. Specific disabilities by age showed some peculiar age patterns that suggest unreliability. Data from the 1984/85 survey show higher sex ratios for all disabilities for certain provinces compared to the national ratios. If the trend accurately reflects increased disabilities, the education of high risk groups must be improved, accessibility to medical care must be increased, and the population needs to be educated about the disabled. Government social programs need more accurate assessments of the causes of disability and the extent and duration of disablement.
 ...
PMID:The population of persons with disabilities in Pakistan. 1231 84

A study was undertaken to investigate the possibility that female leprosy patients in South Eastern Nigeria may be at a disadvantage with regard to early presentation for diagnosis and the prevention of disability. A hospital-based retrospective examination of case notes for the period 1988-1997 was undertaken, totalling 2309 adult patients of whom 1527 (66 degrees/a) were male and 782 (33%) were female (confirming the usual 2:1 male:female ratio for this disease). Data were collected on 1) the clinical type of leprosy, 2) the interval between the onset of symptoms or signs and presentation for diagnosis and treatment and 3) the patterns of physical deformity/disability. The results indicate that in this part of Nigeria, female leprosy patients have a much longer period (duration of illness) between first symptoms or signs and presentation for diagnosis, compared with males; on average, the period before diagnosis in women was almost twice as long as that in men. Furthermore, they suffered a higher proportion of disabilities. There was no evidence to support discrimination against females with leprosy by the health staff or community and female health workers were available in both hospital and primary health care centres to receive and examine female patients. The Discussion refers to the many studies already published on gender issues, identifying a wide range of social, cultural and economic variables attributed by social structure to men and women, and including the impact of stigma, which may be particularly damaging to women in some situations. The main factors that account for late presentation of females with leprosy in this area have however still to be defined. The consequent higher proportion of disability/deformity in women is obviously of considerable concern, underlining the need for further clinical and social research in this part of Nigeria.
 ...
PMID:Male-female (sex) differences in leprosy patients in south eastern Nigeria: females present late for diagnosis and treatment and have higher rates of deformity. 1244 92


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>