A single dose of rifampicin to prevent leprosy; quantitative analysis of impact on perception, attitudes and behaviour of persons affected, contacts and community members towards leprosy in India, Nepal and Indonesia

Introduction: This study looked at the effect of post-exposure prophylaxis (PEP) with single-dose rifampicin (SDR) and the education given along with SDR-PEP on stakeholders' perception regarding leprosy. It is a side study of the Leprosy Postexposure Prophylaxis (LPEP) Program. Methods: The study was done in LPEP implementation areas in India, Nepal and Indonesia. A before and after survey design was used, with qualitative and quantitative data collection methods. This paper presents the quantitative results. In each country 100 interviews were held with representatives of leprosy patients, contacts and community members, before and 1-1.5 years after starting the LPEP Program. Three tools were used: a knowledge, attitudes and practices questionnaire, EMIC community stigma scale and social distance scale (SDS). Results: The most notable effect at follow-up was increased knowledge regarding leprosy in all stakeholder groups, especially leprosy patients. A positive effect was seen on how people think about persons affected by leprosy, reflected by the lower SDS scores in the contact groups in India and Nepal. No negative effects were found on people's perception and reported behaviour. Participants did express or perceive reluctance to disclose a person's leprosy status, but this did not negatively affect willingness to participate in the LPEP Program. Conclusion: This study showed that implementation of SDR-PEP and accompanied education led to increased knowledge on leprosy among patients, contacts and community members and it had no negative effect on perception. SDR-PEP implementation provides an opportunity for health education, including messages to help reduce stigmatisation of persons affected by leprosy.