Inter-relationships among Delay, Defaulting, Deformity and De-habilitation in Leprosy: Markers for Eradicating Leprosy in India

ABSTRACT

In order to unravel the inter-relationships among the four D's viz. delay, defaulting, deformity and dehabilitation, a critical analyses was taken together on estimating conditional probabilities and their relationship to specific demographic, social and economic factors. In a descriptive, cross-sectional in-depth study design, all the qualitative and quantitative types of social science research methods have been used to collect data from a total representative random sample of 450 leprosy affected persons and their families in rural and urban areas of 2 states of Uttar Pradesh and West Bengal in India. Findings from univariate, bivariate and multivariate analysis confirm the significance of correlation among the 4 D's- delay, defaulting, deformity and de-habilitation; and also independently with all the possible influencing factors viz. type of leprosy, age, gender, religion, marital status, educational status and occupation, except for delay with religion and gender and de-habilitation with religion and type of leprosy. This study also arrives at conclusions that each of the four variables is strongly multiple correlated with the other three variables, may be explained as viz. Delay is responsible for defaulting, deformity and de-habilitation, while defaulting is responsible for deformity and de-habilitation; further Deformity is responsible for delay, defaulting and de-habilitation, subsequently. De-habilitation is the main feature that resulted by and results in delay, defaulting and deformity. Established complex association among the four variables confirms that any intervention addressing any one of the 4D's cannot produce any changes unless the intervention is intended to address all the 4D's simultaneously. The study confirms the need for a three arm social multidrug therapy similar to the medical multidrug therapy, where there would be one arm for curing the medical problems of leprosy, a second arm focusing on empowering the people, and a third arm for advocacy and peoples' full participative involvement.