Associated factors study into the belated screening for leprosy in Benin

Abstract

Introduction In the absence of early treatment, leprosy, a neglected tropical disease, due to Mycobacterium leprae or Hansen Bacillus, causes irreversible grade 2 disability (G2D) numerous factors related to the individual, the community and the health care system are believed to be responsible for its late detection and management. This study aims to investigate the factors associated with belated screening for leprosy in Benin. Methods This was a cross-sectional, descriptive, and analytical study conducted from January 1 to June 31, 2019, involving all patients and staff in leprosy treatment centers and public peripheral level health structures in Benin. The dependent variable of the study was the presence or not of G2D, reflecting late or early screening. We used a logistic regression model, at the 5% threshold, to find the factors associated with late leprosy screening. The fit of the final model was assessed with the Hosmer-Lemeshow test. Results A number of 254 leprosy patients were included with a mean age of 48.24 ± 18.37 years. There was a male dominance with a sex ratio of 1.23 (140/114). The proportion of cases with G2D was 58.27%. Associated factors with its belated screening in Benin were (OR; 95%CI; p) the fear of stigma related to leprosy (8.11; 3.3–19.94; <0.001), multiple visits to traditional healers (5.20; 2.73–9.89; <0.001) and multiple visits to hospital practitioners (3.82; 2.01–7.27; <0.001). The unawareness of leprosy by 82.69% of the health workers so as the permanent decrease in material and financial resources allocated to leprosy control were identified as factors in link with the health system that helps explain this late detection. Conclusion This study shows the need to implement strategies in the control programs to strengthen the diagnostic abilities of health workers, to improve the level of knowledge of the population on the early signs and symptoms of leprosy, to reduce stigmatization and to ban all forms of discrimination against leprosy patients.

Improving experiences of neglected tropical diseases of the skin: Mixed methods formative research for development of a complex intervention in Atwima Mponua District, Ghana

“…Our lack of evidence of a predominant role of stigma in shaping care-seeking choices is consistent with the lack of association observed between stigma and care-seeking or treatment delay among BU-affected people across West Africa [ 38 , 41 , 42 ]. Echoing other studies in Ghana and elsewhere [ 12 , 43 , 44 ], individuals with BU and leprosy tended to be open to multiple causality and willing to try many treatments. Reasons for delays in care-seeking at health facilities were therefore usually either that facility-based care had proven ineffective in the past and/or was too expensive to access, supporting findings about the importance of economic factors in shaping skin NTD care-seeking [ 41 ].…”

Nerve Function Examination as a Screening for Prevention of Disability in Morbus Hansen at Kelet General Hospital, Central Java: A Case Report

“…8 Screening examination of nerve function in leprosy patients is expected to prevent long-term complications. [9][10][11] This study aimed to describe neurological function examination in preventing leprosy disability.…”