02966nas a2200193 4500000000100000008004100001260004400042100001800086700001600104700001600120700001500136700001500151700001900166245010000185856008600285490000700371520238000378022001402758 2025 d bSpringer Science and Business Media LLC1 aArudchelvam U1 aPulendran T1 aSirimanne M1 aPabasara S1 aKahawita I1 aChandraratne N00aStigma of People Affected by Leprosy and its determinants: a cross-sectional study in Sri Lanka uhttps://bmcinfectdis.biomedcentral.com/counter/pdf/10.1186/s12879-025-10537-x.pdf0 v253 a

Background

Leprosy, being a neglected tropical disease, remains a significant public health concern in several parts of the world, especially Sri Lanka, where it has long been associated with stigma. This study aims to assess the stigma faced by People Affected by Leprosy (PAL) undergoing treatment and to identify the factors associated with this stigma.

Methods

A cross-sectional study was conducted among 109 Leprosy affected people attending the Central Leprosy Clinic and all dermatology clinics of the National Hospital of Sri Lanka (Colombo), selected using a consecutive sampling method. Data collection was done through an interviewer-administered questionnaire. Stigma was quantified using a validated and adapted version of the Stigma Assessment and Reduction of Impact (SARI) tool, which evaluates stigma pertaining to four domains: Experienced Stigma (ES), Disclosure Concerns (DC), Internalized Stigma (IS), and Anticipated Stigma (AS). Spearman’s correlation and Mann-Whitney U tests were used to analyze associations, with statistical significance set at 0.05.

Results

The dataset showed a non-normal, right-skewed distribution. The mean total SARI score was 9.82 (SD = 10.23). Disclosure Concerns (rs=-2.66; p = 0.005) and Anticipated Stigma (rs=-3.6; p < 0.001) demonstrated weak - moderate negative correlations with the time since diagnosis. On the other hand, the correlation between time since diagnosis and Experienced Stigma (rs=0.22; p = 0.022) was positive and weak. Participants without disability had significantly lower scores in DC (p = 0.049), IS (p = 0.01), and AS (p = 0.01) compared to those with disability. Patients who did not develop Leprosy reactions displayed significantly lower scores across all SARI domains as well as the total SARI score (all p < 0.05) compared to those who did.

Conclusions

The findings suggest that over time, People Affected by Leprosy become less concerned about disclosing their diagnosis and anticipate less stigma but may experience greater overall stigma. Disability status and Leprosy reactions are key factors in determining the level of stigma faced by them.

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