LEPROSY quality of life declined as stigma, poor sleep, depression, and anxiety compounded disability in Ethiopia.
Leprosy Quality of Life Linked to Stigma
Leprosy quality of life was closely tied to stigma, psychological distress, sleep disturbance, and disability in a cross-sectional study of 370 adults receiving care or rehabilitation services at urban leprosy centers in Ethiopia.
The study found that the burden of leprosy extended well beyond visible disease. More than two-thirds of participants had visible deformities, 41.9% had Grade 2 disability, and 23.8% had Grade 1 disability. Delayed diagnosis, defined as at least 2 years after symptom onset, was reported in 53% of cases, while poor living conditions affected 84.05% of participants.
Median global quality of life was 61, with an interquartile range of 56–68. Social relationships were the most affected WHOQOL-BREF domain, with a median score of 7, indicating that social isolation and relationship disruption remained central concerns regardless of disability grade.
Mental Health and Sleep Burden
Poor sleep was common, with a median Pittsburgh Sleep Quality Index score of 8. Only 11.9% of participants had good sleep quality, while 60.8% had moderate sleep disturbance and 27.3% had severe sleep disturbance.
Depression affected 26.2% of participants, while anxiety affected 24.3%. Median PHQ-9 and GAD-7 scores were both 5, consistent with mild depression and mild anxiety. Depression was more common among individuals at an advanced disease stage and among those with Grade 2 disability. Anxiety was also highest among participants with Grade 1 or Grade 2 disability and those in lower income groups.
Stigma was reported in 26.2% of participants, and nearly two-thirds of those experiencing stigma were at an advanced disease stage. Higher stigma scores correlated with higher anxiety and depression scores and lower global quality of life. Stigma was also associated with poorer sleep quality, reinforcing its role as a driver of both psychological and functional burden.
Education and Social Support May Protect Well-Being
Higher education, younger age, and absence of depression were associated with better leprosy quality of life, particularly across environmental, psychological, and physical health domains. Participants who had completed at least primary school reported significantly higher global quality of life than those with no formal education.
Moderately severe depression was significantly associated with lower global quality of life. The findings support integrated leprosy care that addresses disability, mental health, sleep quality, stigma reduction, education, and social reintegration, rather than focusing on clinical disease management alone.
Reference
Chala TK et al. Quality of life, stigma, and mental health, in individuals affected by leprosy: a cross-sectional study. Trans R Soc Trop Med Hyg. 2026; DOI: 10.1093/trstmh/trag064.
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