Around 30 years ago, leprosy affected millions of people worldwide. The World Health Assembly (predecessor to the World Health Organisation - WHO) began its elimination campaign setting an elimination target for leprosy of less than 1 case per 10,000 population by the year 2000. Despite achieving this goal, leprosy remains a significant human health issue in many developing and underdeveloped countries.
In 2016, over 214,000 new cases were reported to the WHO with more than 80% of newly detected cases residing in the subtropical regions of India, Brazil, Ethiopia, Bangladesh, and Indonesia. In some countries, achieving the elimination target was only temporary, while for others, this target has never been reached. From the early 1980s, the treatment for leprosy has been freely available and accessible worldwide, thanks to the generosity of donors.
For small Pacific Island nations, the burden of disease from both non-communicable diseases and communicable diseases are major challenges. Leprosy contributes to the high burden of these communicable diseases in Kiribati. Of the 218 new cases (prevalence of 19.6 per 10,000 population) of leprosy detected in 2016, 36% were children (age 15 years or less). This indicates ongoing transmission and persistence of leprosy.
If the treatment is available free of charge and cure is possible, why does leprosy remain a health problem in some parts of the world? Studies and commentaries regarding leprosy have indicated that individual and structural factors may be contributing to the delay in seeking help for people affected by leprosy.
This study aimed to explore the lived experience of i-Kiribati people with leprosy as investigating their stories and experiences will help to provide a deeper understanding of issues that are important to those with this disease. The overall objective therefore, was to gain further information that could contribute to avoiding delayed diagnosis and promote eventual eradication of leprosy from Kiribati.
In-depth interviews were conducted with 7 participants in Kiribati.
Delay in presentation and diagnosis is an ongoing issue. Important factors that affect delays for the participants in the study include limited awareness and knowledge of leprosy, traditional and cultural beliefs, and stigma.
Public Health and health promotion initiatives need to be country and context specific for best outcomes. Collaboration and partnerships are vital for the success of Public Health programmes in the ongoing battle to eliminate, control and eventually eradicate leprosy from Kiribati.