The consequences of leprostigma
Leprostigma in society causes many patients with active leprosy to delay or avoid treatment (35). In Kaur and Ramesh’s research (48), nearly 77.4% of female leprosy patients in Delhi were afraid of receiving confronting questions about leprosy. Furthermore, Pelizzari et al. (49) found that some medical professionals even advised their patients to avoid discussing leprosy in public. These actions of avoiding mentioning or admitting leprosy are obstacles to improving the public understanding of leprosy and may delay the identification of many leprosy patients (49, 50). This delay is especially harmful to the future of leprosy patients since a lack of treatment in the early stages may worsen symptoms, increase complications and transmissions to those in close contact, and increase the risk of deformities (50).
In General Health Questionnaire (GHQ)-based studies, leprosy patients scored highly (a higher score indicates worse mental health condition and quality of life), and hence were prone to experiencing psychiatric morbidity (51). Among the observed psychiatric conditions, depression (up to 71%), suicide (attempts) (around 33%), and anxiety disorders (10 to 20%) were the most frequently recorded. In addition to these diagnostic conditions, leprosy patients also had a higher identification of neuropsychiatric conditions and negative feelings such as sleep disorder and fear, respectively (51). Compared to other skin diseases, leprosy patients were more likely to suffer psychiatric disorders (52).
In a systematic review, Dijkstra et al. (53) evaluated the effect of gender on leprostigma and found significant gender inequality in leprostigma. Their results revealed that compared to males, leprostigma had a greater effect on female leprosy patients in health, psychological, and social domain; the lattermost was analyzed at family and community levels. Additionally, one study published after the previous systematic review evaluated the effect of gender on leprostigma in Korea (54). In this study, more women than men considered themselves disowned by and separated from their families. Regardless of the extent and subjectivity of the suffering, their findings indicate a greater frequency of discrimination among women solely due to their gender, similar to the results of the previous systematic review.
The effect of leprostigma can extend to the families of the leprosy-affected. According to a recent systematic review that investigated the family members of leprosy patients regarding mental health, children of the leprosy-affected exhibit low self-esteem, worry about contracting the disease, higher depressive symptoms, and low health-related QoL (51). Another article evaluated the impact of leprosy, podoconiosis, and lymphatic filariasis on family quality of life in Northwest Ethiopia (55). This study found that both leprosy patients and their family members experienced frequent discrimination. Finding a partner and maintaining marriage proved especially difficult for leprosy-affected individuals, and this struggle even applied to their family members. Furthermore, the additional task of caring for the affected individual caused family members to experience stress, and at times, discontinue their education (55).
