Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Heidinger, M.
Leprosy Disabilities – Complications of the Poorest?
Retrospective Analysis of Social Determinants of Health and Disability Scores in Leprosy Affected Persons in Salem, Tamil Nadu, India
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2019. pp. 103
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Grisold Andrea
- Pfeifer Johann
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- Abstract:
- Leprosy has consistently been associated with inequities in social determinants of health (SDH) concerning its transmission and infection, as well as its probability for a successful cure. India, the country in which this investigation took place still shows the highest Annual New Case Detection (ANCD) rate globally. Salem, the district in which this study took place shows the highest rate of grade-2 disabilities at diagnosis (G2D). The objective of this study was to determine whether unequal structural mechanisms, a lower socioeconomic status and therefore inequities in SDH correlate with higher severity of disabilities in persons affected by leprosy. This analysis was based on a sampled population of persons, who were enrolled in the lifelong-care program of the Doctor Typhagne Memorial Charitable (DTMC) Trust, had completed a multidrug therapy (MDT) for leprosy and/or were slit-skin smear negative and showed grade-1 disabilities or higher due to leprosy. A descriptive analysis as well as a multiple stepwise linear regression analysis was performed. The Eyes-Hands-Feet (EHF) score was the outcome variable, and gender, age, time after release from treatment, monthly income, and living space were explanatory variables. There were 123 participants, comprised of 41 (33.33%) women and 82 (66.67%) men. All study participants belonged to India’s Backward classes; 81.30% were illiterate and the average monthly income was 1252 Indian rupee (INR) (US$19.08 or €17.16). The average EHF score was 7.016 (95% CI, 6.595 to 7.437). Stepwise multiple linear regression analysis built a significant model, where F(2, 120) = 13.960, p ≤ 0.001, effect size (Cohen’s f2) = 0.81, explaining 18.9% of the variance in EHF scores (R2 = 0.189). Significant predictors of a higher EHF score in persons affected by leprosy were found to be higher age (beta = 0.340, 95% CI, 0.039 to 0.111, p < 0.001), as well as less living space (beta = 0.276, 95% CI, 0.041 to 0.011, p = 0.001). Our results suggest, that persons affected by leprosy live in poor living standards and that inequities in SDH correlate with higher disabilities in persons affected by leprosy.