A Literature Review: The History of Psychological Impact of Illness amongst People with Leprosy (PwL) in Countries across the Globe

Abstract

Background. Leprosy is a chronic infectious disease for which effective therapy has been long since invented. Thus, the morbidity has been decreased as technology has advanced, but the permanent disability has continuously generated stigma for centuries. The stigma causes the emergence of a poor psychological impact on people with leprosy (PwL). These impacts make new PwL reluctant to get appropriate therapy for their initial symptoms and are, thus, troublesome in accomplishing the goals of the leprosy elimination program. The aim of this review is to provide the history of psychological impact amongst PwL in countries across the globe. Methods. This is a literature review study. A keyword-based search was conducted in digital libraries. Articles reporting on PwL’s psychology and related issues, such as quality of life, opportunity of building a marriage, and getting hired, were included. The data were presented based on a leprosy history timeline with cutoff points, namely, the invention of promin (1941) and multidrug treatment (1970). Results. In total, 38 studies were included in this review. These studies showed that PwL’s knowledge towards leprosy has been increasing; nevertheless, their attitude is still lacking. The emotional response was described by various negative feelings that had persistently occurred. These poor psychological impacts were followed by poor treatment-seeking behavior and resulted in low quality of life. Conclusions. From year to year, the PwL’s knowledge about leprosy has been getting better; nevertheless, their attitude towards the disease is still poor. The emotional response, social participation, and quality of life of PwL are persistently poor due to the persistent stigma.

Leprosy and its impact on the quality of life of people with physical disabilities: a scoping review

“…Regarding the study settings, specialized healthcare predominated in 14 studies ( 5 , 8 , 20 , 23 - 24 , 26 , 28 , 31 - 34 , 36 , 43 - 44 ) , followed by primary healthcare in 13 studies ( 5 , 18 , 20 , 24 , 26 , 29 , 31 , 33 , 35 , 37 , 41 , 43 , 47 ) , and hospital healthcare in 7 studies ( 9 , 18 - 19 , 25 , 40 , 44 , 46 ) .…”

“…When portraying the impacts of psychological aspects, the stigma and self-stigma caused by the disease generate negative social and emotional consequences that can result in high levels of social distancing in the community ( 8 ) . These cases are more frequent in individuals with GIF2, lower family income, and lower educational levels.…”

“…This is due to the significant stigma of the disease that intensifies feelings such as anxiety, sadness, fear, low self-esteem, sleep disorders, and even suicidal thoughts. Consequently, many affected individuals feel guilt and shame for contracting the disease, leading to impairments in interpersonal relationships ( 8 , 20 , 29 , 34 ) . Psychotherapy can facilitate understanding of the physical and emotional condition, as well as the reorganization of body image and improvement of self-esteem ( 5 ) .…”

“…On the other hand, improving the quality of care for this population may involve actions of self-care, reducing sequelae, emotional and social impacts, and engagement in treatment and rehabilitation ( 8 - 9 ) . In this sense, detecting convergence between the disease’s sequels and aspects of quality of life can contribute to directing health actions.…”

Improved leprosy elimination efforts in Somalia, 2015–2021: achievements in a challenging environment and the way forward

“…[2][3][4] Consequently, persons affected by leprosy and their families are subject to stigma, discrimination and social exclusion that have become synonymous with the disease since ancient times. [5][6][7] WHO recommends that diagnosis relies on the presence of at least one of three cardinal signs: (i) definite loss of sensation in a pale (hypopigmented) or reddish skin patch; (ii) thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve; or (iii) presence of acid-fast bacilli in a slit-skin smear. 8,9 A delay in diagnosis points to low awareness among health staff and the community, challenges in care accessibility and social issues such as stigma.…”