Problems and coping strategies of families having patients with and without deformities.

Deformity in leprosy is a major problem causing serious socio-economic and psychological consequences to the patients and their families, as well as for the programmers. This paper examines the nature and extent of social and economic problems of leprosy-affected families having patients with and without deformities and their strategy to cope with those problems. The data were collected from 500 sampled families in two monotherapy districts in Tamilnadu in 1989-1990. About 20% of the families reported facing socioeconomic problems. The proportion of families having patients with deformities facing problems was ten times higher (57.3%) than those having patients with no deformities (5.7%). Majority of the problems of the affected families were economic. The major strategy adopted to deal with economic problems was to adjust within the earnings of other family members to make up the loss or reduction in income from the patient. The major social problem faced was denial of participation in the community. While families with deformed patients adopted "acceptance of their existing situation," families with non-deformed patients adopted "avoidance" as their coping strategy. Appropriate rehabilitation programmes to restore economic security to the patients and their families is called for. There is also the need to educate the community about the disease in order to dispel the myths and fears associated with leprosy.

Changing scenario of birthweight in south India.

Reducing incidence of low birthweight and increasing mean birthweights are now considered seriously in the national action plans. Comparison of birthweights obtained over two decades from the representative random segments of rural and urban areas of North Arcot Ambedkar district, Tamil Nadu, India, were studied. Although statistically significant (p < 0.001), the mean birthweight shows only a marginal increase of 70 g from 2774.5 g (+/- 500.2) in 1969-73 to 2845.4 g (+/- 451.0) in 1989-93. The mean birthweight stratified by area and gender also revealed similar increase. On the other hand, the proportion of low birthweight (< 2500 g) newborns reduced significantly from 27.2% to 15.9% in rural and 19.1% to 10.8% in urban area over the decades (p < 0.001). The increase in the mean birthweight and the decline in the percentage of low birthweight newborns over the years was greater in rural than the urban community, but the rural newborns continued to weigh lesser than their urban counterparts.

Variables influencing regularity of leprosy patients in attending treatment clinics.

Regularity in attending clinics as well as taking drugs assume a very significant place in leprosy control programme since irregularity of leprosy patients can lead to poor disease control, drug resistant disease, and development of physical deformities and disabilities thus leading to programme failure. Further, these complications also create socio-economic and psychological problems to the victims as well as their families in myriad ways. This paper reports a study aimed at identifying the variables, among a set of 29 selected demographic, socio-economic and disease-related variables, having significant association with regularity of leprosy patients in attending treatment clinics. It was found that age of the patients, type of family, duration of the disease, time lag between diagnosis of the disease and starting treatment and knowledge of patients and their families about the disease were significantly associated with treatment regularity.