Socio-cultural and Environmental Risk Factors for Leprosy in Jaffna District, Sri Lanka

Abstract

This study was conducted to determine the socio-cultural and environmental risk factors of leprosy in Jaffna. A case-control study was conducted in dermatology clinic, teaching hospital, Jaffna from July 2015 to July 2016. All 97 cases and 291 controls by systematic sampling were recruited using interviewer-administered questionnaire.The mean age of cases was 41 (SD=21) and control was 48 (SD=20). Of 97 cases, 54.6 %( n=53) males; 99 %( n=96) Tamils; 79.4 %( n=77) Hindus; 60 %( n=59) above secondary education. Of 291 controls, 42.3 %( n=123) were males; 99.3 %( n=289) Tamils; 85.6 % (n=249) Hindus; 78.4 % ( n=225) above secondary education.Socio demographic factors (12 variables), house and environmental factors (11 variables), and behavioral factors (18 variables) were included in bivariate analysis and many were found to be significantly (p<0.05) associated with leprosy. Marital status, displacement, monthly income, presence of BCG scar, firewood as cooking fuel, and hunting reptiles were not found to be associated with leprosy. Multiple logistic regression analysis showed significant association between leprosy and - crowded household [OR4.5, (1.5-13.6)], non-availability of drinking water within 30 minutes walking [OR15.1, (2.3-98.3)], environment with shrub [OR2.9, (1.4-6.1)], exposure to shrub [OR2.7, (1.2-5.9)], exposure to leprosy patient [OR10.6, (4.1-27.5)], exposure to fishing [OR4.5, (1.5- 13.6)], visits to leprosy affected area [OR10.8, (4.7-24.5)] and unavailability of safe water source [OR3.3, (1.2- 9.1)]. In addition to the well-known risk factors environment-related risk factors, especially exposure to jungle/shrubs could play a role in the transmission of leprosy.