Abstract
Background: Lack of knowledge about leprosy exists even among medical practitioners around the world. This study was designed to assess the knowledge, attitude and treatment practice regarding leprosy among final year medical students and medical interns in southeast Nigeria. Methods: This was a comparative cross sectional study. All final year medical students and all medical interns in five tertiary health institutions in southeast Nigeria were included in the study. Information was obtained using pre-tested, self-administered, semi-structured questionnaires. Chi square test and multivariate analysis using binary logistic regression were used in the analysis. Significance was determined to be p < 0.05. Results: Of the 1045 respondents (interns 477, response rate: 81.1% and medical students 568, response rate: 97.2%), only 29.0% of medical interns and 24.7% of medical students had a good knowledge of leprosy. A positive attitude towards leprosy care was found in 49.9% and 38.4% of medical interns and students respectively. Clinical demonstration workshops on leprosy were attended by 24.5% and 25.7% of medical interns and students, respectively. Predictors of a good knowledge of leprosy included having attended a clinical demonstration on leprosy, (AOR = 2.9; 95% CI: 2.1–3.9). Predictors of a positive attitude included male gender, (AOR = 1.8; 95% CI: 1.4–2.3) and having a good knowledge of leprosy, (AOR = 1.6; 95% CI: 1.2–2.2). Predictors of good treatment practice included having attended a clinical demonstration on leprosy, (AOR = 2.1; 95% CI: 1.5–2.9) and having a good knowledge of leprosy, (AOR = 2.0; 95% CI: 1.4–2.7). Conclusions: The study highlighted huge knowledge and attitude deficits regarding leprosy among young medical professionals in southeast Nigeria. Emphasis should be on improving practical knowledge of leprosy through clinical demonstrations, to avoid a dearth of leprosy expertise in future generations.
Highlights
In Nigeria, neglected tropical diseases including leprosy are among the forty communicable and non-communicable diseases and conditions included in Integrated Disease Surveillance and Response.[1]
Comparable proportions of medical interns, 88.3% and medical students were of the opinion that leprosy is curable, (χ2 = 0.623, p = 0.430)
A higher proportion of the medical students, 29.0% had good knowledge of leprosy when compared with medical interns, 24.7% but the difference in proportions was not found to be statistically significant, (χ2 = 2.440, p = 0.118)
Summary
In Nigeria, neglected tropical diseases including leprosy are among the forty communicable and non-communicable diseases and conditions included in Integrated Disease Surveillance and Response.[1]. At national level, the proportion of newly diagnosed cases with WHO Grade 2 disability has increased from 12% in 2005 to 28% in 2018, implying late presentation of cases, while the proportion of children among new cases was as high as 9.4% in 2005 but reported to be 4% in 2018. These figures may suggest a trend towards under-detection of leprosy in children, and late detection in adults. The corresponding figures for WHO Grade 2 disability rate and child proportion among new leprosy cases notified in 2018 in southeast Nigeria were 31% and 2% respectively.[1,3] leprosy remains a public health problem in Nigeria, it has been shown that the country is faced with loss of expertise in the clinical management of leprosy.[4]
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