BackgroundThough Nepal declared leprosy elimination in 2010, its burden is constantly rising in Terai communities for the past 2 years with 3000 new leprosy cases being diagnosed annually. Community’s perception is important for prevention and control of leprosy and enhancing quality of life of leprosy patients. Poor knowledge, unfavorable attitude and stigma create a hindrance to leprosy control. The main objective of this study was to assess the knowledge, attitude and stigma of leprosy amongst the community members living in Dhanusha and Parsa districts of Southern Central Nepal.MethodsA total of 423 individuals were interviewed using a structured questionnaire in Dhanusha and Parsa districts. Data was analyzed using both descriptive (frequency, percentage, median) and statistical inferences (Chi-square test, Kruskal Wallis H test, Mann Whitney U test, binary logistic regression) using SPSSvs20.ResultsAll respondents had heard about leprosy. Source of information on leprosy was mainly found to be health workers/hospitals (33.1%). Only 62.6% reported bacteria being its cause followed by other myths such as bad blood/curse/heredity/bad deeds (36%). Only 43.8% responded that leprosy is transmitted by prolonged close contact with leprosy patients and 25.7% reported religious rituals as the treatment. Only 42.1% had good knowledge and 40.9% had favorable attitude. Good knowledge of leprosy was highly associated with favorable attitude towards leprosy (P<0.001). The outcome variables- knowledge, attitude and EMIC score were found to have highly significant association with age, sex, ethnicity, religion, education and occupation of the respondents (P<0.001). Having knowledge on leprosy transmission was positively associated with favorable attitude towards leprosy (P<0.001).ConclusionsStrategizing the awareness programmes according to socio-demographic characteristics for enhancing the knowledge regarding leprosy cause, symptoms, transmission, prevention and treatment, can foster the positive community attitude towards leprosy affected persons. Enhancing positive attitude towards leprosy affected persons can reduce the community stigma, thus may increase their participation in the community. Positive attitude may further increase their early health seeking behaviour including their quality of life.

75% of the cases and 10.04% of the deaths have been reported from Asia. While India alone accounted for 395,812 cases and 12,970 deaths, Indonesia reported 43,803 cases and 12,970 deaths, and Nepal ranked 25th among Asian countries with 8,274 cases and 22 deaths due to COVID-19. The increasing burden of COVID-19 accompanied by travel restrictions, lockdown measures, and restrictions on social gatherings and activities have disrupted several lives. Not only a health crisis has been brought by the COVID-19 pandemic: It is affecting societies and economies at their core and will most likely increase poverty and inequalities at a global scale, making achievement of Sustainable Development Goals (SDGs) even more urgent [2]. Moreover, the nationwide lockdown accompanied by travel restrictions have been threatening all citizens, with greater impact on vulnerable social groups (including those affected with leprosy) for accessing healthcare services in particular. People of all ages can be infected by COVID-19. However, the elderly and people with preexisting medical conditions appear to be more vulnerable to becoming severely ill with the virus, according to WHO [3]. Leprosy is a mycobacterium infectious disease affecting peripheral nerves. Leprosy-affected people with leprosy-related reactions could be one of the conditions for being at high risk of COVID-19 infection [4]. Worldwide, there are 23 global priority countries for leprosy as per its burden. As per data in 2019, 79.6% of the new leprosy cases are concentrated in India, Brazil, and Indonesia. Countries of the South East Asian Region (SEAR) constitute 71% of the global new cases, with India and Indonesia attributing 92% of the case burden in the region [5]. Despite the declaration of leprosy elimination in 2010, the prevalence of leprosy increased from 0.77 in 2010 to 0.83 in 2014 in Nepal [6]. Nepal is among the global priority countries of leprosy in SEAR, with an increase in new cases from 3,054 in 2016 to 3,249in 2018, an increase in new grade 2 disability (G2D) cases from 87 in 2017 to 133 in 2018, and an increase in pediatric cases in 2018 [5]. Leprosy can be cured through treatment via drugs, and the treatment in the early stages can prevent disability among the leprosy affected people [7]. However, if remained untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs, and eyes [7]. This makes early diagnosis of leprosy an efficient way of treatment,as the damages are irreversible. Even after treatment, many patients are left with deformities, sores, cracked skin, and amputated limbs [8].

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There has been a growing burden of anxiety among Nepalese adolescents. Social anxiety in particular is one of the commonly reported symptoms indicating mental health problem among adolescents. The purpose of this study was to assess social anxiety, and identify how social support, emotion regulation and mindfulness uniquely contribute to social anxiety among adolescents in Birgunj, Nepal. The study was conducted by using a self-administered questionnaire among 384 adolescents (65.4% boys; M = 16.05 years, SD = 1.39) studying at secondary schools of Birgunj. Results show that there was a positive correlation between social anxiety symptoms and age, and girls reported more symptoms. Traits such as non-acceptance of emotions, lack of clarity and lack of awareness of emotions were related to increased social anxiety; while acting with awareness, non-reactivity, and better ability to describe emotions was related to decreased social anxiety. Finally, more social support from close friends was related to lower social anxiety. These results suggest that improving emotion regulation, dispositional mindfulness, and social support may be helpful for adolescents who are at risk of, or are suffering from, social anxiety.