The Interplay of Stress and Salivary Cortisol Saliva in Multibacillary Leprosy: A Cross-Sectional Analysis in South Sulawesi, Indonesia

Abstract

Background: Leprosy remains a significant health concern in Indonesia, particularly in South Sulawesi, where the prevalence rate has reached 0,78 per 10,000 population. The increasing number of new cases, mainly of the multibacillary type, poses a serious epidemiological and clinical challenge. Leprosy patients often face social stigma, leading them to live in isolation, causing additional stress for the patients. Stress triggers various physiological responses, including the activation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullary (SAM) system. Cortisol, the primary glucocorticoid secreted by the adrenal cortex, is the end product of the HPA axis. In the salivary glands, cortisol exists only in its active form, different from its presence in the serum. Objective: To analyze salivary cortisol levels and correlate them with the stress scale in multibacillary leprosy patients Methods: This study used a descriptive-analytic approach with a cross-sectional method. Twenty-five samples in Makassar from November 2022 to January 2023, with the criteria of those newly diagnosed with multi-bacillary leprosy based on clinical and laboratory examination, participated. The stress scale was assessed with the Perceived Stress Scale-10 (PSS-10). Using enzyme-linked immunosorbent assay (ELISA) to measure saliva cortisol levels. Result: The correlation for the stress scale with the cortisol saliva levels shows a negative correlation with salivary cortisol levels in this study showing a mean value of 67,76 ng/ml and a significance value of 0.000. Conclusion: There is a negative correlation between stress scale and salivary cortisol levels. The more severe the stress, the lowest cortisol saliva level