Introduction
Leprosy remains a serious public health concern in Nigeria, with over
3500 people diagnosed each year and approximately 25% of these patients
suffer from one form of
disability or the other . Before Nigeria’s independence in 1960, Nigeria
had a leprosy prevalence of more than 20% . In conformity with existing
global thinking and practice at the time, leprosy communities were
developed to preserve public health and provide relief to men and women
suffering from the disease.
Even though Nigeria achieved the national leprosy elimination target of
less than 1/10,000 population in 1998 , some factors like culture,
behavioural patterns, and social determinants, among others, are still
contributing to more leprosy cases Tuberculosis and Leprosy Control
Program (NTBLCP) started as a program in 1989 . Between 1991 and 2012,
111,788 leprosy patients were effectively treated with MDT (Multi-Drug
Resistant Treatment), and the country was also able to meet another
target which is the WHO eradication target of fewer than one case per
10,000 people in 2000 . With a case detection rate of less than 5% per
10,000 persons, Nigeria is currently classified as low endemic for
leprosy, however, at the sub-national level, there are areas of “high
endemicity” where leprosy prevalence remains at up to 1 instance for
every 10,000 persons .
In 2019, 10% (20,205) of global
leprosy cases were recorded in Africa with Nigeria and 12 other
countries reporting 1000 – 10,000 cases . Studies from high leprosy
endemic countries have shown that leprosy shows marked uneven
geographical distribution even within the smallest community groups such
as villages and households . This is one of the motivations for this
research as people living with leprosy are mostly living in isolated
communities outside main towns and cities.
Some other motivation for this study is the lack of publication and
inadequate conversation about the level of care available for people
living with leprosy in Nigeria. In Nigeria, we cannot compare the level
of reporting tuberculosis gets to that of leprosy even by the National
TB and Leprosy Control Programme (NTBLCP). The National Tuberculosis and
Leprosy Control Program (NTBLCP) is an integral part of the Nigerian
Ministry of Health with the role of coordinating and implementing
national strategies, policies, and programs for the control and
management of tuberculosis (TB) and leprosy in Nigeria. Some of the
program’s responsibilities encompass policy development, strategic
planning, program coordination, capacity building, monitoring and
evaluation, advocacy and awareness, and research and innovation.
Meanwhile, the level of stigma and disdain experienced by some people
living with leprosy is so disheartening as leprosy is seen as the most
terrible and despised disease in some areas of Nigeria .
The stigma has long-term negative consequences for people with
disabilities, including loss of employment, social ties, and reputation,
difficulties finding a life partner, divorce, and discrimination . As a
result, leprosy is frequently referred to as a social killer The stigma
associated with leprosy is sometimes more distressing than the disease
itself . Some leprosy patients have frequently described how they are
denied some social and economic opportunities. Some are also rejected by
family members and society. These events have repercussions on their
psychological health. Some because of stigma and disdain, therefore,
postpone receiving treatment until difficulties appear .
Nigeria through the Federal Ministry of Health and the National
Tuberculosis and Leprosy Program and partners has successfully treated
over 33,000 leprosy patients across the country since 2009 till date;
this has been made possible through funding from donors and
non-governmental organizations . International Federation of
Anti-Leprosy Associations (ILEP) is a consortium of organisations that
provides relief and rehabilitation services to persons affected with
leprosy and their efforts are complemented by efforts from other
organizations outside ILEP. ILEP organisations include; The leprosy
mission, Nigeria (Coverage is nationwide), the Damien Foundation (Covers
the South-Western states and Kwara state with a coverage population of
over 56 million people), and DAHW German Leprosy and TB Relief
Association (area of coverage is South-East and South-South, Nigeria) .
Nigeria has made some level of progress in the fight against leprosy.
However, to record tangible progress there is a need for the Nigerian
government to increase its commitment to leprosy control and elimination
by working alongside partners to ensure effective and sustainable
leprosy control in line with the 2021-2025 global leprosy strategy .This
study explored the experiences of people living with leprosy, the
experiences of healthcare workers, and the conditions of living in the
leprosy settlements.