Advertisement

Modelling the Effects of Stigma on Leprosy

  • Stephen G. Mosher
  • Christian Costris-Vas
  • Robert SmithEmail author
Conference paper
  • 43 Downloads
Part of the Springer Proceedings in Mathematics & Statistics book series (PROMS, volume 302)

Abstract

The World Health Organization’s leprosy-elimination campaign has significantly reduced global leprosy prevalence, but approximately 214,000 new cases of leprosy are reported each year. An ancient and neglected affliction, leprosy is also one of the most heavily stigmatised diseases of all time. We developed a mathematical model to examine the effects of stigma on sustaining disease transmission, using low and high degrees of stigma, as well as in its absence. Our results show that stigma does indeed play a central role in the long-term sustainability of leprosy. We also examined sensitivity of the outcome to all parameters and showed that the effects of stigma could increase the number of infected individuals by a factor of 80. Therefore both targeted education and shifts in cultural attitudes towards leprosy will be necessary for the eventual eradication of the disease.

Keywords

Leprosy Stigma Mathematical model Latin Hypercube Sampling Partial rank correlation coefficients 

Notes

Acknowledgements

The authors are grateful to Alison Kealey and Nyuk Sian Chong for invaluable assistance and are also grateful to an anonymous reviewer for insightful comments that greatly improved the manuscript. RS? is supported by an NSERC Discovery Grant. For citation purposes, please note that the question mark in “Smith?” is part of the author’s name.

References

  1. 1.
    Blok, D., de Vlas, S., Fischer, E., Richardus, J.: Mathematical modelling of leprosy and its control. Adv. Parasitol. 87, 33–51 (2014)CrossRefGoogle Scholar
  2. 2.
    Blower, S., Dowlatabadi, H.: Sensitivity and unvertainty analysis of complex models. Int. Stat. Rev. 62, 229–243 (1994)CrossRefGoogle Scholar
  3. 3.
    Cross, H., Choudhary, R.: STEP: an intervention to address the issue of stigma related to leprosy in Southern Nepal. Lepr. Rev. 76, 316–324 (2005)Google Scholar
  4. 4.
    Dara, S., Gadde, R.: Epidemiology, prognosis, and prevention of leprosy worldwide. R. Curr. Trop. Med. Rep. (2016)Google Scholar
  5. 5.
    Fischer, E., Vlas, D., Meima, A., Habbema, D., Richardus, J.: Different mechanisms for heterogeneity in leprosy susceptibility can explain disease clustering within households. PLoS ONE 5 (2012)CrossRefGoogle Scholar
  6. 6.
    Kealey, A., Smith?, R.: Neglected tropical diseases: infection, modelling and control. J. Health Care Poor Underserved 21, 53–69 (2010)Google Scholar
  7. 7.
    Kumaresan, J., Maganu, E.: Socio-cultural dimensions of leprosy in North-Western Botswana. Soc. Sci. Med. 39, 537–541 (1994)CrossRefGoogle Scholar
  8. 8.
    Lechat, M., Misson, C., Lambert, A.: Simulation of vaccination and resistance in leprosy using an epidemiometric model. Int. J. Lepr. 53, 461–467 (1985)Google Scholar
  9. 9.
    Link, B.G., Phelan, J.C.: Conceptualizing stigma. Annu. Rev. Sociol. 27, 363–385 (2001)CrossRefGoogle Scholar
  10. 10.
    Lockwood, D., Suneetha, S.: Leprosy: too complex a disease for a simple elimination paradigm. Bull. World Health Organ. 83, 230–235 (2005)Google Scholar
  11. 11.
    Lustosa, A., Nogueira, L., Pedrosa, J., Teles, J., Campelo, V.: The impact of leprosy on health-related quality of life. Revista da Sociedade Brasileira de Medicina Tropical 44, 621–626 (2011)CrossRefGoogle Scholar
  12. 12.
    Meima, A., Gupte, M., Oortmarssen, G.V., Habbema, J.: Simlep: a simulation model for leprosy transmission and control. Int. J. Lepr. Other Mycobact. Dis. 67, 215–236 (1999)Google Scholar
  13. 13.
    Merle, C., Cunha, S., Rodrigues, L.: BCG vaccination and leprosy protection: review of current evidence and status of BCG in leprosy control. Expert. Rev. Vaccines 9, 209–222 (2012)CrossRefGoogle Scholar
  14. 14.
    Mg, W.: Stigma and the social burden of neglected tropical diseases. PLoS Negl. Trop. Dis. 2, e237 (2008)CrossRefGoogle Scholar
  15. 15.
    Mushuyabasa, S., Bhunu, C.: Modelling the effects of chemotheraphy and relapse on the transmission dynamics of leprosy. Math. Sci. 6, 12 (2012)CrossRefGoogle Scholar
  16. 16.
    Rafferty, J.: Curing the stigma of leprosy. Lepr. Rev. 76(2), 119–126 (2005)Google Scholar
  17. 17.
    Richardus, J., Habbema, J.: The impact of leprosy control on the transmission of M. leprae: is elimination being attained? Lepr. Rev. 78(4), 330–337 (2007)Google Scholar
  18. 18.
    Rodrigues, L., Lockwood, D.: Leprosy now: epidemiology, progress and research gaps. Lancet Infect. Dis. 11(6), 464–470 (2011)CrossRefGoogle Scholar
  19. 19.
    Sengupta, S., Banks, B., Jonas, D., Miles, M.S., Smith, G.C.: HIV interventions to reduce HIV/AIDS stigma: a systematic review. AIDS Behav. 15, 1075–1087 (2011)CrossRefGoogle Scholar
  20. 20.
    Smith, W., Anderson, A., Withington, S., Van Brakel, W., Croft, R., Nicholls, P., Richardus, J.: Steroid prophylaxis for prevention of nerve function impairment in leprosy: randomised placebo controlled trial (tripod 1). Br. Med. J., 328 (2004)Google Scholar
  21. 21.
    Suzuki, K., Akama, T., Kawashima, A., Yoshihara, A., Yotstu, R., Ishii, N.: Current status of leprosy: epidemiology, basic science and clinical perspectives. Adv. Exp. Med. Biol. 582, 22–33 (2012)Google Scholar
  22. 22.
    Tsutsumi, A., Izutsu, T., Islam, M.D.A., Amed, J.U., Nakahara, S., Takagi, F., Wakai, S.: Depressive status of leprosy patients in Bangladesh: association with self-perception of stigma. Lepr. Rev., 57–66 (2004)Google Scholar
  23. 23.
    van Brakel, W.H., Sihombing, B., Djarir, H., Beise, K., Kusumawardhani, L., Yulihane, R., Kurniasari, I., Kasim, M., Kesumaningsih, K.I., Wilder-Smith, A.: Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination. Glob. Health Action 5, 18394 (2012)CrossRefGoogle Scholar
  24. 24.
    Weiss, M., Ramakrishna, J., Somma, D.: Health-related stigma: rethinking concepts and interventions. Pyschology Health Med. 11(3), 277–287 (2006)CrossRefGoogle Scholar
  25. 25.
    World Bank: Crude birth rate for developing countries in Middle East and North Africa (2016)Google Scholar
  26. 26.
    Yang, L.H., Kleinman, A., Link, B.G., Phelan, J.C., Lee, S., Good, B.: Culture and stigma: adding moral experience to stigma theory. Soc. Sci. Med. 64, 1524–1535 (2007)CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Stephen G. Mosher
    • 1
  • Christian Costris-Vas
    • 2
  • Robert Smith
    • 3
    Email author
  1. 1.Department of Earth and Environmental SciencesThe University of OttawaOttawaCanada
  2. 2.Department of MathematicsThe University of OttawaOttawaCanada
  3. 3.Department of Mathematics and Faculty of MedicineThe University of OttawaOttawaCanada

Personalised recommendations