title: Impacts of the diagnosis of leprosy and of visible impairments amongst people affected by leprosy in Cebu, the Philippines.
abstract: OBJECTIVE
  To quantify the impact of the diagnosis of leprosy and of visible impairments in people affected by leprosy.
  
  
  METHODS
  Three interview-based questionnaires designed to measure activity limitation, participation restriction, and general self-efficacy were used to collect data from three Groups. Group 1: leprosy affected people with visible impairment, Group 2: newly diagnosed leprosy patients with no visible impairment, Group 3: patients with other skin diseases symptomatic for more than 1 month.
  
  
  RESULTS
  One hundred and eight subjects were recruited. The subjects with visible impairments (Group 1) had higher levels of participation restriction than those with skin disease (P0.012), and participation restriction was similar between subjects in Groups 2 and 3 (P0-305). The people in Group 1 (35 subjects) also reported significantly more activity limitation compared to the people in either Group 2 (35 subjects) or Group 3 (38 subjects) (P 0-001, respectively). The subjects in Group 2 had no significant activity limitation compared with those in Group 3 (P0.338). A multivariate analysis showed that severe visible impairment was a risk factor for activity limitation (odds ratio 5.68, 95% CI: 1.09-297, P0.039) and a low level of self-efficacy (Odds ratio 6.38, 95% CI: 1.06-38.3, P0-043) among people affected by leprosy.
  
  
  CONCLUSIONS
  Visible impairments affected the activities and attitudes of people affected by leprosy. However, others without visible impairment, had activity limitations, participation restrictions and levels of general self-efficacy that were similar to patients with other skin diseases. Prevention of visible impairments should be considered a key intervention for stigma reduction.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, UK. noriko.boku@gmail.com
authors.forename: Noriko
authors.initials: N
authors.lastname: Boku
authors.forename: Diana N J
authors.initials: DN
authors.lastname: Lockwood
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Balagon
authors.forename: Fe Eleanor F
authors.initials: FE
authors.lastname: Pardillo
authors.forename: Armi A
authors.initials: AA
authors.lastname: Maghanoy
authors.forename: Irene B
authors.initials: IB
authors.lastname: Mallari
authors.forename: Hugh
authors.initials: H
authors.lastname: Cross
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D007918:Leprosy / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D010679:Philippines / Q000453:epidemiology; D011594:Psychometrics; D012307:Risk Factors; D020377:Self Efficacy; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012934:Social Isolation; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult