Community knowledge, perceptions and attitudes regarding leprosy in rural Cameroon: The case of Ekondotiti and Mbonge health districts in the South-west Region

BackgroundAlthough leprosy is one of the oldest diseases known to humanity, it remains largely misunderstood. Misconceptions about leprosy lead to stigma towards people with the disease. This study aimed at exploring the knowledge, perceptions and attitudes regarding leprosy in rural Cameroon.MethodsWe carried out a cross-sectional community survey of 233 respondents aged 15–75 years, free from leprosy, and living in two rural health districts of the South-west Region of Cameroon. A questionnaire designed to evaluate knowledge, perceptions and attitudes about leprosy was used. Binary logistic regression was used to determine independent predictors of negative attitudes.ResultsAbout 82% of respondents had heard about, and 64.4% knew someone with leprosy. Information on leprosy was mainly from community volunteers (40.6%), friends (38.0%), and the media (24%). Only 19.7% of respondents knew the cause of leprosy, and a considerable proportion linked it to a spell (25.3%), unclean blood (15.5%) and heredity (14.6%). About 72% knew that leprosy is curable and 86.3% would advise medical treatment. Attitudes towards leprosy patients were generally negative. Only 42% would shake hands, 32.6% would share the same plate, and 28.3% and 27% respectively, would allow their child to play or marry a person with leprosy. Furthermore, only 33.9% approved of participation of leprosy patients, and 42.9% of their employment. Independent predictors of negative attitudes were: the belief that leprosy is a curse; is caused by a germ; and having seen a leprosy patient. The negative attitudes were dampened by: the beliefs that leprosy is a punishment, is hereditary and is due to poor personal hygiene.ConclusionAn awareness intervention using community volunteers and the media, with information on the cause of leprosy, its clinical manifestations and curability, and sensitization messages correcting the misconceptions and beliefs regarding leprosy, could improve the community knowledge and attitudes towards leprosy. This would ultimately contribute to the reduction of leprosy burden in the community.

【背景】麻风病（leprosy）是人类已知的最古老疾病之一，但时至今日仍未被广泛理解。对麻风病的认知误区会导致社会对该病患者产生污名化。本研究旨在探究喀麦隆农村地区人群对麻风病的认知、看法与态度。
【方法】本研究针对喀麦隆西南部地区两个农村卫生辖区内的233名年龄介于15至75岁、未罹患麻风病的常住居民开展横断面社区调查（cross-sectional community survey）。研究采用专为评估麻风病相关认知、看法与态度设计的调查问卷，并通过二元logistic回归（Binary Logistic Regression）分析确定负向态度的独立预测因素。
【结果】约82%的受访者曾听闻过麻风病，64.4%的受访者认识麻风病患者。受访者获取麻风病相关信息的主要渠道为社区志愿者（40.6%）、亲友（38.0%）及媒体（24%）。仅19.7%的受访者知晓麻风病的病因，且有相当比例的人群将其归因于巫术诅咒（25.3%）、血液不洁（15.5%）与遗传因素（14.6%）。约72%的受访者知晓麻风病可治愈，86.3%的受访者会建议患者接受药物治疗。人群对麻风病患者的态度整体偏负面：仅42%的受访者愿意与患者握手，32.6%愿意与患者共用餐盘，分别仅有28.3%与27%的受访者允许自己的子女与麻风病患者一同玩耍或结婚。此外，仅有33.9%的受访者认可麻风病患者参与公共活动，42.9%的受访者支持麻风病患者就业。负向态度的独立预测因素包括：认为麻风病是诅咒、由病菌引起，以及曾见过麻风病患者；而认为麻风病是一种惩罚、具有遗传性且源于个人卫生不良的观念，则会缓解负向态度。
【结论】借助社区志愿者与媒体开展宣传干预，普及麻风病的病因、临床表现及可治愈性相关知识，并通过宣教纠正公众对麻风病的认知误区与错误观念，可提升社区人群对麻风病的认知水平与正向态度，最终助力减轻社区的麻风病疾病负担。