Health workers’ perceptions of leprosy and factors influencing their perceptions in endemic countries: A systematic literature review

Abstract

Objectives To review work done to date on the perceptions of health workers towards leprosy and persons affected by leprosy. We aimed to create an overview of the different perceptions, review the differences and commonalities, and examine the drivers of these perceptions. Methods A systematic literature review was conducted in PubMed, Web of Science, PsycINFO and Infolep.org. Results The search identified 503 articles, 21 articles were included in the review. The findings show knowledge gaps among health workers, and varying levels of negative attitudes towards persons affected by leprosy, which are influenced by local beliefs and by emotions such as fear. For example, we found that not all health workers are willing to treat persons affected by leprosy, often out of fear of contamination. We found that perceptions differed between countries, regions, health facilities and between different types of health workers. Factors associated with ‘positive’ perceptions of leprosy include male gender, knowing someone affected by leprosy, having received in-service training on leprosy, having graduated over five years ago, having received formal education on leprosy, and having knowledge of leprosy. Conclusions Health care workers’ perception of leprosy varied greatly between countries and by context. We found knowledge gaps and diverse local beliefs that may contribute to negative attitudes, which are also influenced by fear of leprosy. It is important to examine perceptions of leprosy and to contextualise interventions when designing interventions to change health workers’ perceptions of leprosy. Future interventions may consider including elements found to be determinants of a ‘positive’ perception in this review (for example, in-service training).