Prevalence of multimorbidity.

IntroductionLeprosy remains a public health challenge in India, with many individuals continuing to experience physical disability, stigma, and psychosocial burden despite being cured. While co-occurrence of individual comorbidities such as diabetes and depression has been reported, the prevalence and patterns of multimorbidity among persons affected by leprosy remain poorly documented.MethodsWe conducted a mixed-methods study across six tertiary referral hospitals of The Leprosy Mission in India during 2021–2022. Quantitative data were extracted from electronic medical records of 10,428 adults affected by leprosy, including clinical details, random blood sugar, haemoglobin, cataract assessment, and wellbeing status measured using the WHO-5 index. Multimorbidity was defined as the presence of ≥2 conditions in addition to leprosy. Logistic regression was used to identify associated factors. Qualitative data were collected through focus group discussions (FGDs) with 16 persons affected by leprosy and 14 healthcare providers and analyzed thematically.ResultsLeprosy alone was present in 81.9% of participants, while 16.4% had one additional condition, and 1.7% experienced multimorbidity. Diabetes was the most frequent comorbidity (9.3%), followed by poor wellbeing (5.6%) and cataract (1.5%). Increasing age, male gender, and disability were significantly associated with multimorbidity. FGDs revealed limited awareness of multimorbidity, challenges in accessing integrated care, financial barriers, and absence of flexible guidelines for management.Discussion & conclusionAlthough relatively uncommon (1.7%), multimorbidity among persons with leprosy poses substantial challenges. Diabetes, mental health concerns, and malnutrition highlight the need for integrated, person-centred care models. Strengthening primary healthcare, enhancing screening, and developing multimorbidity-sensitive guidelines are essential to improve outcomes, reduce stigma, and promote holistic wellbeing in this marginalized population.引言 麻风病（Leprosy）仍是印度面临的一项公共卫生挑战，即便患者已实现临床治愈，仍有众多人群持续承受躯体残疾、病耻感与社会心理负担。尽管已有研究报道了糖尿病、抑郁症等单一共病的共现情况，但麻风病患者群体中多重共病（multimorbidity）的患病率与分布模式仍鲜有文献记载。 研究方法 本研究于2021—2022年间在麻风病救助会（The Leprosy Mission）旗下的6家印度三级转诊医院开展，采用混合研究设计。研究人员从10428名成年麻风病患者的电子病历中提取定量数据，内容包括临床细节、随机血糖、血红蛋白水平、白内障筛查评估结果，以及采用WHO-5幸福感指数量表测得的健康状况。本研究将多重共病（multimorbidity）定义为除麻风病外，同时存在≥2种其他疾病；采用逻辑回归分析筛选相关影响因素。此外，研究人员通过与16名麻风病患者及14名医疗服务提供者开展焦点小组讨论（focus group discussions, FGDs）收集定性数据，并进行主题分析法分析。 研究结果 仅患麻风病的参与者占总样本的81.9%，16.4%的参与者仅伴发1种其他疾病，仅1.7%的参与者存在多重共病。糖尿病是最常见的共病（9.3%），其次为幸福感低下（5.6%）与白内障（1.5%）。年龄增长、男性性别与躯体残疾与多重共病存在显著相关性。焦点小组讨论结果显示，受试者对多重共病的认知水平有限，同时存在整合式照护获取困难、经济障碍以及缺乏灵活的管理指南等问题。 讨论与结论 尽管麻风病患者的多重共病发生率相对较低（1.7%），但仍带来了诸多严峻挑战。糖尿病、心理健康问题与营养不良问题凸显了构建整合式、以患者为中心的照护模式的必要性。加强初级卫生保健服务、提升筛查水平以及制定适配多重共病的管理指南，对于改善该边缘群体的治疗结局、降低病耻感以及促进整体健康幸福感至关重要。