ArticlePLoS neglected tropical diseases2017
"I Wasted 3 Years, Thinking It's Not a Problem": Patient and Health System Delays in Diagnosis of Leprosy in India: A Mixed-Methods Study.
Article in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Establishing a standard method for analysing case detection delay in leprosy using a Bayesian modelling approach.Infectious diseases of poverty · 2023Pooled it
- Delayed detection of leprosy cases: A systematic review of healthcare-related factors.PLoS neglected tropical diseases · 2022Pooled it
- Individual and community factors determining delayed leprosy case detection: A systematic review.PLoS neglected tropical diseases · 2021Pooled it
- Understanding patient pathways and care delays in India: implications for early leprosy detection.Public health action · 2026Article
- Experiences and perceptions on diagnostic delay of leprosy by affected people in Colombia: A qualitative study.PLoS neglected tropical diseases · 2026Article
- Peripheral Nerve Ultrasound Findings in Leprosy: A Scoping Review of Echogenicity, Cross-Sectional Area, and Vascularization Across 15 Studies.Clinical, cosmetic and investigational dermatology · 2026Review
- Mental Health Awareness and Stigma in the General Population: A Mixed-Methods Approach in Semi-Urban Areas.Cureus · 2025Review
- Associated Factors of Mycobacterium Leprae Infection among People with Leprosy in Kwale County.PLoS neglected tropical diseases · 2025Article
- Roadmap towards zero leprosy, Pakistan.Bulletin of the World Health Organization · 2025Article
- Article
- The Epidemiological Impact of Community-Based Skin Camps on Leprosy Control in East Hararghe Zone, Ethiopia: a Modelling Study.Journal of epidemiology and global health · 2025Article
- Anti-PGL-I seropositivity and development of leprosy in contacts: a comprehensive analysis of sociodemographic determinants, genetic susceptibility, and exposure characteristics to Mycobacterium leprae.Memorias do Instituto Oswaldo Cruz · 2025Article
- Implementation fidelity in leprosy care and support for disability prevention and management in Rupandehi, Nepal: A qualitative study.PloS one · 2025Article
- Mental health and stigma in persons affected by Hansen's disease and their families in rural Sitapur, India.PLOS mental health · 2025Article
- Case detection delay in leprosy: Testing tool reliability and measurement consistency in Ethiopia, Mozambique, and Tanzania.PLoS neglected tropical diseases · 2024Article
- Article
- Improving experiences of neglected tropical diseases of the skin: Mixed methods formative research for development of a complex intervention in Atwima Mponua District, Ghana.PLOS global public health · 2024Article
- Measuring leprosy case detection delay and associated factors in Indonesia: a community-based study.BMC infectious diseases · 2023Article
- Beliefs, attitudes and practices towards scabies in central Ghana.PLoS neglected tropical diseases · 2023Article
- Prolonged delays in leprosy case detection in a leprosy hot spot setting in Eastern Ethiopia.PLoS neglected tropical diseases · 2022Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWorldwide, leprosy is one of the major causes of preventable disability. India contributes to 60% of global leprosy burden. With increasing numbers of leprosy with grade 2 disability (visible disability) at diagnosis, we aimed to determine risk factors associated with grade 2 disability among new cases and explore patients and providers' perspectives into reasons for late presentation. METHODOLOGY/PRINCIPAL
findingsThis was an explanatory mixed-methods study where the quantitative component, a matched case-control design, was followed by a qualitative component. A total of 70 cases (grade 2 disability) and 140 controls (grade 0) matched for age and sex were randomly sampled from new patients registered between January 2013-January 2015 in three districts of Maharashtra (Mumbai, Thane and Amaravati) and interviewed using a structured close ended questionnaire. Eight public health care providers involved in leprosy care and 7 leprosy patients were purposively selected (maximum variation sampling) and interviewed using a structured open-ended interview schedule. Among cases, overall median (IQR) diagnosis delay in months was 17.9(7-30); patient and health system delay was 7(4-16.5) and 5.5(0.9-12.5) respectively; this was significantly higher than the delay in controls. Reasons for delayed presentation identified by the quantitative and qualitative data were: poor awareness of leprosy symptoms, first health care provider visited being private practitioners who were not aware about provision of free leprosy treatment at public health care facilities, reduced engagement and capacity of the general health care system in leprosy control.
conclusionsRaising awareness in communities and health care providers regarding early leprosy symptoms, engagement of private health care provider in early leprosy diagnosis and increasing capacity of general health system staff, especially targeting high endemic areas that are hotspots for leprosy transmission may help in reducing diagnosis delays.
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