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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We sent a questionnaire to members of Yokohama Medical Association and Departments of University Hospital to get an overview of leprosy patients in the clinic. Yokohama Medical Association: The rate of collection was approximately 47%. Few doctors have taken medical care of Leprosy patients. Half of the doctors will take medical care, but they have little information about Leprosy. Aged doctors do not take medical care compared with young doctors. Departments of University Hospital: The rate of collection was approximately 74%. Doctors in the University Hospitals do not hesitate to take medical care of leprosy patients. Dermatologists actively take medical care and have a chance of getting information about leprosy. It is necessary to give doctors information about leprosy and its history of stigma.
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PMID:[Summary of questionnaires on leprosy in Yokohama City area and university hospitals]. 1550 22

Leprosy is a chronic disease that leads to physical disability as a result of nerve damage. Stigma and associated psychosocial problems are common and may increase the risk of mental disorders. This study was conducted to estimate the prevalence of mental distress amongst people attending a Specialized Leprosy and Dermatology Hospital, ALERT, Addis Ababa. Alternate patients from the daily register of outpatients were interviewed for symptoms of mental distress using the Self Reporting Questionnaire (SRQ). This questionnaire was administered by two specially trained nurses. The study population consisted of 786 people. Of these, 60% had leprosy and the remainder had other skin diseases. The sex distribution of the study population was approximately equal. The overall prevalence of mental distress was found to be 34.6%. Among people with leprosy the prevalence was 52.4%, compared with 7.9% in those with other skin conditions. This represented a 7-fold increased risk of mental distress in people with leprosy, adjusted OR = 7.14 (95% CI; 4.15, 12.35). Physical disability was also strongly associated with mental distress. This study showed that the 1-month prevalence of mental distress was significantly higher in patients with leprosy compared to patients with other dermatological conditions. Such a study allows identification of non-specific mental distress. Thus, future work should be directed at further characterizing the nature and severity of mental disorder in this group. However, our study has indicated a need for the integration of psychosocial care into our current medical treatment of patients with leprosy.
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PMID:Prevalence of mental distress in the outpatient clinic of a specialized leprosy hospital. Addis Ababa, Ethiopia, 2002. 1624 14

Leprosy in Nepal is a stigmatizing disease. This paper explores the different coping strategies employed by people affected by leprosy to manage stigma. It is based on a qualitative study conducted in the eastern part of Nepal. It will show that a difference exists between experienced stigma and the anticipation of stigma. Both types of stigma result in different coping strategies. In managing stigma people go through different phases. This paper will show that stigma is a dynamic process, and I will elaborate on the concealment cycle, as developed by Hyland, to produce a more detailed understanding of the stigmatization process in Nepal. Doing so, it highlights the importance of a mutual concealment phase and the importance of triggers to exposure and discrimination. Changing from one phase to a subsequent phase in the stigmatization process is always triggered. It highlights further, that even within the same culture and even the same village, social differentiation makes a significant difference on the impact of stigma and the coping strategies employed in managing stigma. Stigma enforces already existing inequalities in social class, gender, and age.
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PMID:The dynamics of stigma in leprosy. 1575 98

Can leprosy be eliminated? This paper considers the question against the background of the WHO programme to eliminate leprosy. In 1991 the World Health Assembly set a target of eliminating leprosy as a public health problem by 2000. Elimination was defined as reaching a prevalence of < 1 case per 10 000 people. The elimination programme has been successful in delivering highly effective antibiotic therapy worldwide. However, despite this advance, new-case detection rates remain stable in countries with the highest rates of endemic leprosy, such as Brazil and India. This suggests that infection has not been adequately controlled by antibiotics alone. Leprosy is perhaps more appropriately classed as a chronic stable disease than as an acute infectious disease responsive to elimination strategies. In many countries activities to control and treat leprosy are being integrated into the general health-care system. This reduces the stigma associated with leprosy. However, leprosy causes long-term immunological complications, disability and deformity. The health-care activities of treating and preventing disabilities need to be provided in an integrated setting. Detecting new cases and monitoring disability caused by leprosy will be a challenge. One solution is to implement long-term surveillance in selected countries with the highest rates of endemic disease so that an accurate estimate of the burden of leprosy can be determined. It is also critical that broad-based research into this challenging disease continues until the problems are truly solved.
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PMID:Leprosy: too complex a disease for a simple elimination paradigm. 1617 32

This article examines the biocultural dynamics of social discrimination and physical disfigurement among people with leprosy, or Hansen's disease (HD), in Banaras, northern India. Based on the narratives and observations ofpeople living in colony and street settings, I trace three destructive processes by which the social stigmata of leprosy become physically expressed. First, strategies of concealment further the progression and spread of HD through late detection and undertreatment. Second, the internalization of stigma can lead to bodily dissociation and injury through self-neglect. Finally, some people intentionally seek injuries under conditions of desperate poverty. As a result of such mortification processes, these people came to embody, quite literally, the prejudices that exacerbated their condition in the first place.
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PMID:Self-mortification and the stigma of leprosy in northern India. 1597 28

The stigma of leprosy is a real phenomenon in many people's lives that affects their physical, psychological, social and economical well-being. There are many causes for this damaging image of leprosy. There is no one easy answer to dispelling this image; it is something that has to be done in partnership with communities and patients. Many papers document the effects of stigma, but few discuss or trial solutions. Education and media campaigns counteract false beliefs about leprosy and raise awareness of new advances in the field. Leprosy care is increasingly provided in an integrated setting showing patients and their communities that leprosy is not a disease apart. Physical and socio-economic rehabilitation is worthwhile in restoring self worth and status in the community and helps patients to find employment. Group counselling can allow those with leprosy to talk about their feelings and experiences to empower one another. Gradually attitudes towards leprosy are changing, but there is still much to be done if the underlying menace of stigma is to be dealt with. We as health professionals must be prepared to make the first move and give that first touch. Certainly more research is needed. In the highly endemic countries the road to elimination may yet be long. Perhaps with effort we will one day be able not only to treat the disease, but also to cure the stigma of leprosy, and make that road an easier one.
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PMID:Curing the stigma of leprosy. 1603 45

Despite enhanced disease control efforts, leprosy remains an important cause of disability in several countries. Being based on case detection, the exact prevalence of the disease is not easily estimated. Currently around 600,000 new cases are treated annually. Advances in immunology and molecular biology have led to a greater understanding of the disease and to hopes for improved diagnostic tests and vaccination strategies. The major advance, though, is the development of highly effective combination drug regimens which, provided all doses are taken, rarely fails to cure. The challenge to leprosy control services is to overcome the stigma associated with the disease so that patients present with minimal lesions and before disabilities have developed. Although it is hoped that leprosy as a serious public health problem will be eliminated within a few years, continuing care for those suffering from deformity and rejection by society will be required for several decades.
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PMID:Leprosy of the past and today. 1608 69

Dermatologic disorders generally have a major impact on patients' daily activities, psychologic and emotional state, and social relationships. The intensity of impact of skin disease on an individual person is extremely variable, however, and depends on natural history of the disorder; the patient's demographic characteristics, personality, character, and value; the patient's life situation; and the attitudes of society. Social stigma toward dermatologic disorders in the Indian society is quite widespread, especially toward leprosy. Dermatologists are expected to consider quality of life issues along with social aspects, nature of disorder, efficacy, and tolerability of various therapeutic options to optimize relief and comfort to their patient.
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PMID:Stigma experience in skin disorders: an Indian perspective. 1611 39

Leprosy which has caused stigma and social ostracism for millennium is nearing elimination worldwide as a public health problem, but the leprosy burden in Nepal is still 4.4 times greater than WHO's target level of less than one case per 10,000 population. Although leprosy affects both the sexes, in most parts of the world males are affected more than females at a ratio of 2:1. The general objective of the study was to investigate the gender difference in socio-epidemiological factors for leprosy. The analytic cross-sectional study was carried out in one of the most hyper endemic district- Dhanusa district of Nepal. Stratified random sampling method was applied for the selection of the patients. Chi-square/Fisher's exact test was applied to assess statistically significant differences in values between males and females. There were 580 leprosy patients (385 male and 195 female) aged above 15 years registered for multi drug therapy between April 1, 2001 to March 31,2002 in the 16 main health centers of the district. Out of 580 patients, 273 patients (183 males and 90 females) were included in the study in order to collect the data on socio-demographics, patient's knowledge on leprosy, treatment seeking behaviour, and social problems faced by the patients. Data were collected using a structured interview schedule. The mean age of the male patients was 45.1 years (range 15-77 years) and female patients were 40.3 years (range 15-75 years). Among male patients 93.4% were married while among female patients 70.0% were married. Among male patients 51.9% were illiterate whereas 71.1% were illiterate among female patients. Most of the patients (69.6%) lived in joint family and the rest in nuclear family. Among male patients, 86.9% had good knowledge about the disease compared to 73.3% among females. This study showed that among the female patients 12.2% were facing high level of social problems, while among male patients only 4.4% were facing the same. About 15% patients had poor treatment seeking behaviors (8.2% among males and 27.8% among females). A significant gender differences among leprosy patients have been found in age distribution, educational status, marital status, caste types, family members, and overall knowledge on the general aspect of leprosy, social problems faced by the patients and treatment seeking behaviour.
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PMID:Gender difference in socio-epidemiological factors for leprosy in the most hyper-endemic district of Nepal. 1629 38

Leprosy, manifesting during adolescence when significant physical and emotional changes are taking place, poses further stress and strain both on the individual and on the family. Based on hospital records, focus group discussions and in-depth interviews, data on 258 adolescent leprosy patients seen at a leprosy referral hospital in Kolkata, India, are presented. The male-female sex ratio was 1.93:1, 56.6% were multibacillary patients and 13.2% had grade 2 disability. At the time of final follow up, 10% of PB and 33% of MB patients had already discontinued treatment. The commonest complication was reaction (14.5%). Adolescents were still dependent on their parents for health matters. Data obtained from questionnaires confirmed the role of social stigma in hiding, delay in starting of MDT and defaulting. Frequent hospital admissions resulted in loss of jobs and disruption of studies and caused psychological disturbances. It is critical to identify and treat adolescent leprosy on a priority basis. Health education and counselling programmes must be more focused and acceptable. Further research is necessary.
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PMID:Leprosy among adolescents in Kolkata, India. 1635 23


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