Factors associated with disability among patients with leprosy: a scoping review

Hansen's disease, often known as leprosy, is a chronic infectious disease caused by Mycobacterium leprae that mostly affects peripheral nerves, the skin and mucous membranes. Notwithstanding improvements in diagnosis and treatment options, many patients with leprosy remain severely disabled, which negatively impacts their quality of life and social interaction. Determining the factors associated with the development of disability in patients with leprosy is essential for developing successful therapeutic plans. For the purpose of this review, disability is defined according to the WHO grading system as any impairment of the eyes, hands, or feet caused by leprosy (Grade 0-2). This review aimed to identify the factors associated with disability among patients with leprosy. The guiding research question was: What are the factors associated with the occurrence of disability in patients with leprosy?. This study employed a scoping review following the guidelines provided in the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Literature searches were conducted using two databases and search engines, namely PubMed, Scopus, and Google Scholar. Articles included in the review were published in English and Indonesian between 2019 and 2023, a period selected to capture the most recent evidence reflecting contemporary clinical practices and disability assessment approaches in leprosy management. Eligible studies were selected and analyzed after approval. The quality of the evidence was assessed using the Joanna Briggs Institute (JBI) criteria. Data extraction was carried out using a standardized form that captured information on study characteristics, participant demographics, and key findings related to factors influencing the disability among patients with leprosy. This review analyzed 10 articles, identifying 12 factors that influence the disability in patients with leprosy. These factors include the type of leprosy, duration of the disease, leprosy reactions, the number of affected nerves, delays in treatment or diagnosis, socioeconomic status, gender, occupation, education level, treatment adherence, self-care, and social support. These influencing factors were categorized into three groups: demographic factors, internal factors, and external factors. These findings highlight the complex interplay of various factors contributing to disability in patients with leprosy, emphasizing the need for targeted interventions that address both individual and systemic issues to improve patient outcomes.