The trajectory of illness and the pattern of care seeking by leprosy patients in a leprosy endemic district of bangladesh

Abstract

Background Persons affected by leprosy usually prefer to hide their condition and often come to the health facility after visible Grade 2 disabilities start to appear. They are unaware of the diagnosis or of the subsequent consequences and decline to seek care at the early stage of the disease progression. This study aims to describe the trajectory of this illness and the patterns of care seeking by leprosy patients in Bangladesh. Methods This qualitative study relied on in-depth interviews in Nilphamri district which is known to be a leprosy endemic district in Bangladesh. Persons affected by leprosy over 18 years of age with a Grade 2 disability were selected for interview. A total of thirteen respondents were interviewed. Thematic analysis was used to interpret the data to identify themes, explore emerging patterns, and examine commonalities and contradictions. Results Lack of awareness in the general population about leprosy and a poor referral system appeared to be the major barriers to seeking health care at an early stage of disease progression. Persons affected by leprosy remain hidden for a long time because of its slow progression, leading to the development of more devastating disabling conditions. Conclusion Programmes to create awareness about leprosy may help in motivating people to access appropriate health care in a timely manner, and comply with the treatment requirements and recommendations. Location and functions of leprosy clinics should be made known to the surrounding communities. Leprosy affected persons will be more eager to use the service if they know about the facility. Important determinants like the costs and economic burden should be investigated in depth in future studies to help formulate leprosy care policies and strategies.