Leprosy perceptions and knowledge in endemic districts in India and Indonesia: Differences and commonalities.
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
22
07
2020
accepted:
02
12
2020
revised:
02
02
2021
pubmed:
22
1
2021
medline:
18
5
2021
entrez:
21
1
2021
Statut:
epublish
Résumé
Understanding how knowledge, attitudes and practices regarding leprosy differ in endemic countries can help us develop targeted educational and behavioural change interventions. This study aimed to examine the differences and commonalities in and determinants of knowledge, attitudes, practices and fears regarding leprosy in endemic districts in India and Indonesia. A cross-sectional mixed-methods design was used. Persons affected by leprosy, their close contacts, community members and health workers were included. Through interview-administered questionnaires we assessed knowledge, attitudes, practices and fears with the KAP measure, EMIC-CSS and SDS. In addition, semi-structured interviews and focus group discussions were conducted. The quantitative data were analysed using stepwise multivariate regression. Determinants of knowledge and stigma that were examined included age, gender, participant type, education, occupation, knowing someone affected by leprosy and district. The qualitative data were analysed using open, inductive coding and content analysis. We administered questionnaires to 2344 participants (46% from India, 54% from Indonesia) as an interview. In addition, 110 participants were interviewed in-depth and 60 participants were included in focus group discussions. Knowledge levels were low in both countries: 88% of the participants in India and 90% of the participants in Indonesia had inadequate knowledge of leprosy. In both countries, cause, mode of transmission, early symptoms and contagiousness of leprosy was least known, and treatment and treatability of leprosy was best known. In both countries, health workers had the highest leprosy knowledge levels and community members the highest stigma levels (a mean score of up to 17.4 on the EMIC-CSS and 9.1 on the SDS). Data from the interviews indicated that people were afraid of being infected by leprosy. Local beliefs and misconceptions differed, for instance that leprosy is in the family for seven generations (Indonesia) or that leprosy is a result of karma (India). The determinants of leprosy knowledge and stigma explained 10-29% of the variability in level of knowledge and 3-10% of the variability in level of stigma. Our findings show the importance of investigating the perceptions regarding leprosy prior to educational interventions in communities: even though knowledge levels were similar, local beliefs and misconceptions differed per setting. The potential determinants we included in our study explained very little of the variability in level of knowledge and stigma and should be explored further. Detailed knowledge of local knowledge gaps, beliefs and fears can help tailor health education to local circumstances.
Sections du résumé
BACKGROUND
Understanding how knowledge, attitudes and practices regarding leprosy differ in endemic countries can help us develop targeted educational and behavioural change interventions. This study aimed to examine the differences and commonalities in and determinants of knowledge, attitudes, practices and fears regarding leprosy in endemic districts in India and Indonesia.
PRINCIPLE FINDINGS
A cross-sectional mixed-methods design was used. Persons affected by leprosy, their close contacts, community members and health workers were included. Through interview-administered questionnaires we assessed knowledge, attitudes, practices and fears with the KAP measure, EMIC-CSS and SDS. In addition, semi-structured interviews and focus group discussions were conducted. The quantitative data were analysed using stepwise multivariate regression. Determinants of knowledge and stigma that were examined included age, gender, participant type, education, occupation, knowing someone affected by leprosy and district. The qualitative data were analysed using open, inductive coding and content analysis. We administered questionnaires to 2344 participants (46% from India, 54% from Indonesia) as an interview. In addition, 110 participants were interviewed in-depth and 60 participants were included in focus group discussions. Knowledge levels were low in both countries: 88% of the participants in India and 90% of the participants in Indonesia had inadequate knowledge of leprosy. In both countries, cause, mode of transmission, early symptoms and contagiousness of leprosy was least known, and treatment and treatability of leprosy was best known. In both countries, health workers had the highest leprosy knowledge levels and community members the highest stigma levels (a mean score of up to 17.4 on the EMIC-CSS and 9.1 on the SDS). Data from the interviews indicated that people were afraid of being infected by leprosy. Local beliefs and misconceptions differed, for instance that leprosy is in the family for seven generations (Indonesia) or that leprosy is a result of karma (India). The determinants of leprosy knowledge and stigma explained 10-29% of the variability in level of knowledge and 3-10% of the variability in level of stigma.
CONCLUSION
Our findings show the importance of investigating the perceptions regarding leprosy prior to educational interventions in communities: even though knowledge levels were similar, local beliefs and misconceptions differed per setting. The potential determinants we included in our study explained very little of the variability in level of knowledge and stigma and should be explored further. Detailed knowledge of local knowledge gaps, beliefs and fears can help tailor health education to local circumstances.
Identifiants
pubmed: 33476343
doi: 10.1371/journal.pntd.0009031
pii: PNTD-D-20-01319
pmc: PMC7853455
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0009031Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
PLoS Negl Trop Dis. 2019 Jan 11;13(1):e0007075
pubmed: 30633780
BMJ Glob Health. 2019 Mar 7;4(2):e001250
pubmed: 30997168
Lepr Rev. 2006 Mar;77(1):62-8
pubmed: 16715691
Int Arch Med. 2013 Aug 30;6(1):34
pubmed: 24000954
J Public Health Afr. 2011 Mar 03;2(1):e10
pubmed: 28299051
Soc Sci Med. 2007 Jun;64(12):2443-53
pubmed: 17382441
Int J Lepr Other Mycobact Dis. 2004 Dec;72(4):437-47
pubmed: 15755198
Lepr Rev. 2017 Mar;88(1):43-57
pubmed: 30188088
Psychol Bull. 2007 Jul;133(4):673-93
pubmed: 17592961
Psychol Health Med. 2006 Aug;11(3):307-34
pubmed: 17130068
Glob Health Action. 2012;5:
pubmed: 22826694
J Glob Infect Dis. 2011 Oct;3(4):378-82
pubmed: 22224003
Lepr Rev. 2005 Jun;76(2):119-26
pubmed: 16038245
Indian J Lepr. 2013 Jul-Sep;85(3):123-7
pubmed: 24724234
Disabil Rehabil. 2011;33(9):711-9
pubmed: 20690861
J Glob Infect Dis. 2010 Sep;2(3):212-5
pubmed: 20927279
PLoS Negl Trop Dis. 2019 Apr 5;13(4):e0007302
pubmed: 30951526
PLoS Negl Trop Dis. 2014 Nov 06;8(11):e3274
pubmed: 25376007
Soc Sci Med. 1996 Jan;42(1):3-19
pubmed: 8745104
Lepr Rev. 2004 Dec;75(4):327-37
pubmed: 15682970
Lepr Rev. 1998 Mar;69(1):57-74
pubmed: 9628096
Indian J Lepr. 2007 Jan-Mar;79(1):27-43
pubmed: 17578266
Trends Parasitol. 2012 May;28(5):195-201
pubmed: 22475459
Indian J Lepr. 1995 Oct-Dec;67(4):389-403
pubmed: 8849916
J Dermatol. 2012 Feb;39(2):121-9
pubmed: 21973237
Southeast Asian J Trop Med Public Health. 1986 Sep;17(3):427-32
pubmed: 3563610
Lepr Rev. 2006 Jun;77(2):89-98
pubmed: 16895065
Indian J Lepr. 2012 Oct-Dec;84(4):277-85
pubmed: 23720893
J Nepal Health Res Counc. 2013 Sep;11(25):264-8
pubmed: 24908528
Indian J Lepr. 2015 Jan-Mar;87(1):1-16
pubmed: 26591845
Int Health. 2016 Mar;8 Suppl 1:i53-70
pubmed: 26940310
Lepr Rev. 1992 Jun;63(2):157-68
pubmed: 1640784
Schizophr Res. 2009 Dec;115(2-3):363-9
pubmed: 19616414
PLoS One. 2015 Jun 05;10(6):e0129086
pubmed: 26047512
An Bras Dermatol. 2014 Mar-Apr;89(2):205-18
pubmed: 24770495
Indian J Lepr. 2014 Apr-Jun;86(2):27-41
pubmed: 25591277
Soc Work Health Care. 2019 Feb;58(2):151-165
pubmed: 30321131
J Clin Diagn Res. 2016 Mar;10(3):ZC48-52
pubmed: 27135001
Indian J Lepr. 2011 Apr-Jun;83(2):75-80
pubmed: 21972659
Lepr Rev. 1994 Mar;65(1):66-77
pubmed: 8201837
PLoS Negl Trop Dis. 2018 Feb 12;12(2):e0006233
pubmed: 29432474
PLoS Negl Trop Dis. 2015 Oct 20;9(10):e0004003
pubmed: 26485128
Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S69-78
pubmed: 17931139
Lepr Rev. 2000 Dec;71(4):492-8
pubmed: 11201904
Int J Lepr Other Mycobact Dis. 2000 Sep;68(3):299-306
pubmed: 11221093
Lepr Rev. 2015 Mar;86(1):54-61
pubmed: 26065147
Psychol Health Med. 2006 Aug;11(3):277-87
pubmed: 17130065
Lepr Rev. 2014 Mar;85(1):36-47
pubmed: 24974441
Soc Hist Med. 1998 Apr;11(1):89-105
pubmed: 11620156