Risk factors of stigma related to leprosy- A Systematic Review

INTRODUCTION:  Leprosy has long been seen as the epitome of stigmatization and has become a metaphor for degradation in colloquial English. The most common notion of stigma however, still refers to people’s fear of dealing with leprosy-affected people.

METHODS:  To review the articles related to the stigma of leprosy and its risk factors, a literature study was done. References were collected through a PubMed (Medline) search on the keywords “leprosy” combined with “stigma”, “risk factors” “KAP” or “attitude.” A total of 187 papers were displayed by the PubMed (Medline) search. 67 out of 187 papers were selected based on the issues of stigma addressed by them

RESULTS:  

Studies that involve the assessment of stigma can be broadly categorized into two groups: (i) studies that assess the effects of stigma on the person affected and (ii) studies that assess attitudes and/or practices towards people affected by leprosy. In addition, studies can be further categorized into different groups depending on the types of stigma that have been assessed. Most of the studies have assessed all kinds of stigma with or without specifying the particular stigma; however, our review has extracted the types of stigma from the studies.

 There are three kinds of stigma, perceived stigma, enacted stigma and self- stigma.

The consequences of stigma can range from the psychosocial dysfunction to isolation, rejection and participation restriction. Despite the variation in prevalence of different types of stigma, its severity and nature, the risk factors associated with stigma are remarkably similar. They include visible impairments, disability, low socioeconomic status, low education and the various perceptions regarding leprosy. This suggests that risk factors contributing to the development of stigma are perhaps of a similar nature thus indicating that management of stigma in diverse culture is possible by implementing related stigma-reduction strategies to counteract the various risk factors in various settings.

CONCLUSIONS:  

The risk factors of leprosy-related stigma are remarkably similar in different cultural settings. From our literature review, the basis of stigma appears to be the visibility of the disfigurements and disability augmented by the stereotypes of the society, knowledge, and the status of the person in terms of economy, education and ability to participate in society.