Stigma in leprosy: concepts, causes and determinants

TLDR

Leprosy, a chronic infectious disease, has been stigmatized since ancient times, causing significant social and personal difficulties for affected individuals. This review aimed to clarify the concept, causes, and determinants of leprosy‑related stigma. The authors performed a systematic literature search in PubMed, CINAHL, PsycInfo, and Google Scholar, screened 84 records, and ultimately included 54 studies. Stigma in leprosy is multifaceted, encompassing undesirable disease characteristics, cultural and religious beliefs, fear of transmission, and public health interventions, yet similar patterns across cultures suggest common intervention targets.

Abstract

Leprosy is a chronic infectious disease that has stigmatised people affected since ancient times until now. This has resulted in difficulties in the lives of those affected.This literature review was conducted to understand the concept, causes, and determinants of stigma in leprosy.Electronic searches were undertaken using PubMed (Medline), CINAHL and PsycInfo databases. The internet was searched through Google Scholar for papers not found in these databases. The main inclusion criteria were papers related to stigma or leprosy written in Thai or English.After searching the databases, 84 papers were identified, 3 were removed because of duplication and parallel publication, and 20 were removed on abstract screening. After reading 61 full papers, 7 were excluded. Finally, 54 were included in this review. It was found that the concept of stigma involves not only characteristics considered undesirable, but also the social context of the individual or group. Reported causes and determinants of stigma related to leprosy are the external manifestations of the disease, cultural and religious beliefs, fear of transmission, association with people considered inferior and public health-related interventions.Stigma is a complex phenomenon that has multiple causes, often linked to the cultural context in which it occurs. Despite this, many similarities were found in leprosy-related stigma across countries and cultures, which would facilitate the development of interventions.