Study of some factors influencing the high defaulter rate among leprosy patients in the Western Province of Sri Lanka.

Abstract

Non compliance with recommended treatment regimens is a problem in the case of chronic diseases such as leprosy which require long period of uninterrupted treatment. Failure on the part of patients to attend clinics regularly, makes case holding one of the major problems in the leprosy control programme. In this study, an attempt has been made to find out the reason for non-acceptance of treatment services and to ascertain what factors affect the decision making process of the patients. the present study is confined to the medical factors and some of the demographic factors which can conveniently be covered through a quantitative analysis of patients' clinic records. the study area is restricted to the Western Province of Sri Lanka. This study includes a review of all available literature, not only on the subject of case holdings in leprosy, but non-compliance with treatment regimens in general.5681 files of all patients registered in 21 clinics in the western province were scrutinized. Data relating to the factors being studied (age, sex marital status, place of residence, type of leprosy, degree of deformity etc) were obtained from patients clinic records. The clinic attendance history of each patient during the 2 year period was also recorded. The more significant finding was the fact that the above factors taken together accounted of only 17.22 per cent of variance. This finding indicates that the socio-cultural and service factors not covered in the present study may hold the key in explaining the balance 82.78 per cent of variance. The need for further research to examine the role of socio-cultural factors and service factors as contributory causes for the high rate of default, is clearly established. Focusing attention on the providers of services and the service organizations, and not merely the community in carrying out research of this type, is particularly stressed. Suitable research methodologies to study these aspects are suggested