Stigma towards leprosy: A systematic review

Background: One of the many problems that hinder leprosy prevention efforts is the stigma attached to leprosy, people affected by leprosy, and even their families. Stigma against leprosy can lead to discrimination, which will cause leprosy patients to be reluctant to seek treatment. To date, there are still no reviews that discuss the overall picture of the causes, manifestations, and the impact of stigma related to leprosy. This systematic review aims to know the leading causes, manifestations, and the impact of stigma related to leprosy. Methods: Search for inclusion studies was carried out through the PubMed and ScienceDirect databases, resulting in 13 studies included. Six studies used an individual perspective in their research, three studies had a community perspective, and four studies with a combined perspective of individuals and communities. Results: The studies in this review consists of eight cross-sectional studies, two RCT studies, one grounded theory study, one exploratory study, and one study with an unspecified design. A total of 2,636 participants were included in all the studies. The analysis results of all of the included studies indicated that for the factors that cause stigma, eight studies discussed the fear of contracting the disease, 10 studies discussed the external manifestations of the disease and three studies discussed burden on the family. Seven studies discussed cultural and community misconceptions. All studies discussed manifestations of stigma, 10 studies discussed about anticipated stigma, and 11 studies discussed internalized stigma. All studies discussed the social and psychological impacts of stigma related to leprosy, and only 3 studies discussed health impacts. Conclusion: The stigma towards leprosy is mainly caused by external manifestations of the people affected by leprosy, with the main manifestations of avoidance, social exclusion and concealment of the disease, and the main impact of social isolation from the community, reduced employment opportunities, and feeling of shame.