Leprosy disease in Nepal : knowledge and non-compliance of patients

Non-compliance among leprosy patients has always been a problem in Nepal. Many researches on drug compliance has indicated that if a patient understands well about his /her disease and its treatment, he /she is more likely to be motivated to take the whole prescribed course of treatment properly. It is widely believed that the understanding and behavior of patients in relation to drug compliance are largely influenced by their socio-economic condition and level of knowledge. In order to determine the socio-economic characteristics of non-compliant leprosy patients and their level of knowledge of leprosy disease and treatment, a non-intervention study was carried-out in Dhanusha - a high prevalent district in Nepal bordering India. A total of 57 non-compliant leprosy cases were selected using systematic sampling method on the basis of available clinical records and an interview-schedule was used for data collection. The result shows that the majority of non-compliant cases were illiterate, laborers by occupation and from poor economic class family background (73.7%). Data revealed that majority did not understand the cause of the disease and were not aware of the duration of treatment. It was interesting to note that an overwhelming majority (94.7%) were having strong belief that the disappearance of sign/symptoms was the only meaning of the "cure of leprosy disease". In view of this, it is strongly recommended that the patient education and counseling, public/community awareness program should be improved and further strengthened. A socio-economic rehabilitation program with vocational/trade training to leprosy patients or their family members should be arranged to up-lift their socio-economic status.