Senior Specialist and Assistant Professor Department Of Dermatology, ESIC PGIMSR &Model
Hospital, Basaidarapur, New Delhi, India
2 Second year post graduateresident- Department Of Dermatology, ESIC PGIMSR & Model Hospital, Basaidarapur, New Delhi, India
3 Head of Department and Director Professor Department Of Dermatology, ESIC PGIMSR & Model Hospital, Basaidarapur, New Delhi, India
4 Professor Department Of Dermatology, ESIC PGIMSR & Model Hospital, Basaidarapur, New Delhi, India
5 Senior Resident Department Of Dermatology, ESICPGIMSR & Model Hospital, Basaidarapur, New Delhi, India
Corresponding author details:
Sundeep Chowdhry, Senior Specialist and Assistant Professor
Department of Dermatolog
ESIC PGIMSR &Model Hospital
Copyright: © 2018 Chowdhry S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 international License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Objective: To assess the level of knowledge, social attitude towards patients, and diagnostic capabilities of doctors (KAP) regarding leprosy, practicing attertiary care institute of New Delhi, India.
Study Design: Cross-sectional, observational study
Materials and Methods: A pretested and pre-validated questionnaire consisting of 21 questions was administered to 300 clinicians working in various specialities of this tertiary care hospital. The questionnaire covered all aspects of leprosy including clinical features, diagnostic methods, duration of treatment, stigma etc to test the knowledge and attitude of a clinician towards the patient of leprosy. The collective sum of correct answers marked by respondent doctors was taken to classify them. Respondents who marked more than 15 questions correctly were considered to have excellent knowledge, whereas those aggregating 10-15 and 5-10 correct answers were classified to have good and average knowledge respectively. Participants with less than 5 correct answers were marked to have poor knowledge.
Results: A total of 300 doctors were included in the study out of which 262 gave consent to answer the questionnaire. Twenty four doctors (9.18%) doctors had excellent knowledge whereas twenty six (9.92%) doctors had poor knowledge about the disease. Ninety four (35.87%) and one hundred eighteen (45.03%) had average and good knowledge about the disease respectively.
Conclusion: There is deficiency in knowledge and practices about leprosy amongst
clinicians which needs to be improved to bring down the prevalence of this disease globally.
Leprosy; Hansen’s disease
Leprosy is a chronic infectious condition caused by Mycobacterium leprae. This disease is known to mimic various dermatoses as well as many systemic disorders as it has a wide range of clinical presentations. It can present as single hypo pigmented patch with mild to severe hypoanesthesia or can present with a wide range of deformities including loss of vision, deformities of hands and feet, autoamputation, resorption of digits and many others which can be attributed to the multisystem involvement of Hansen disease. Therefore it is prudent to have a good knowledge about this condition so that no case is missed out by the clinician.
The WHO report showed that after 2015 the global registered prevalence of leprosy was
176176 which was 0.18 cases per 10000 population and incidence was 211973 which was
0.21 per 100000 . In India according to the NLEP report of 2015-2016 the prevalence rate
was 0.69 per 100000 population and the annual new case detection rate was 127334 which
translates to 9.71 per 100000 population . It was further reported that state of Bihar
showed highest case detection rate amongst the data available from all other states in the
country. Delhi, being the capital of India, is a central place for all the immigrant population
and this could be a probable cause of high prevalence rate of Leprosy in this region. For a
common person, Medical Officer (General Physician) is usually the first level of interface
with the public and constitutes the backbone of health care services in any country .
Therefore it is necessary to ascertain whether the General practitioner (GP) who refers the
suspected/ affected individual to higher centres for the treatment has adequate knowledge
about the clinical features, progression and outcome of the disease process. In view of above it was proposed to assess level of knowledge, social attitude towards
patients, diagnostic and management capabilities with regards to
various aspects of leprosy in the Medical Officers (MBBS Graduate) of
a tertiary care hospital in New Delhi, India.
This study was conducted in a tertiary care hospital, New Delhi
from the period of April 2017-June 2017. Doctors including Medical
Officers, residents undergoing post graduation as well junior
residents in various specialities of this Hospital were enrolled in
the study. Doctors who had previously worked in leprosy clinics
and those who are presently practicing in Dermatology department
were excluded from the study to avoid bias in the result. A
carefully structured questionnaire comprising of 21 questions was
administered to all doctors included in the study. The questionnaire
was designed to cover various aspects of Hansen’s disease including
the clinical presentations, treatment modalities, attitude towards
patients, leprosy as a social stigma and other parameters pertaining
to the disease. All the questions were either having answers in Yes/No
or in multiple choices. Respondents were asked to tick appropriate
answers in the proforma. Sum of the total correct answers marked by
the respondents were taken to classify knowledge of leprosy amongst
doctors. A score of 0-5 was considered as poor, 6-10 as average, 11-
15 as good and more than 15 as excellent . All the proformas were
evaluated at the end of the survey and the responses obtained were
evaluated using statistical program SPSS version 16.0. Pearson’s Chisquare test was applied among categorical variables .
This study included the response of 300 Medical Officers (MO’s) out of which 262 gave the consent and complied by filling the survey questionnaire. Out of 262 doctors 178 were males (68%) and 84 doctors were females (32%). More than half of MO’s were posted as Medical officers in various specialties. This study also included students undergoing post graduation (48 in number) excluding those who are already working in the department of Dermatology.
Graph (Figure 1) below depicts overall knowledge of leprosy
among practitioners based upon their correct answers. It was found
that a total of 118 doctors (45.03%) had a good knowledge whereas
26 (9.92%) doctors had poor knowledge about the disease. Ninety
four out of 262 (35.87%) had average whereas 24 out of 262(9.18%)
had excellent knowledge. Overall ratio of correct answers was higher
among Post Graduate students in various disciplines as compared to
doctors working as Medical Officer.