Community perspectives on leprosy and related stigma in northern Nigeria: a qualitative study

Aim This study explored community perceptions about leprosy and the extent, root causes, and drivers of stigma in Kano State, northern Nigeria. Methodology The study used a cross-sectional design with a qualitative approach. Semi-structured in-depth interviews were conducted with community members unaffected by leprosy. Participants were selected using stratified purposive sampling. Thematic analysis was performed based on the “Framework Approach”. Results A total of 21 community members were included in this study. We found that the majority of the participants perceived persons affected by leprosy negatively, they were considered dirty, incurable, and inferior. Participants indicated that they avoid touching, social interactions, and sharing meals with persons affected by leprosy. In addition, leprosy was said to negatively impact employment opportunities and the marriage prospects of persons affected and their family members. Marriage prospects were considered worse for women affected by leprosy. We identified four main drivers of stigmatization: (1) local beliefs and misconceptions about leprosy (e.g. the belief that leprosy is hereditary, incurable, or highly infectious), (2) fear of disability and deformity, (3) fear of infection, and (4) perceived poor personal hygiene of persons affected. Conclusion This study revealed negative perceptions regarding leprosy, including misconceptions about etiology, fear and desire to keep social distance towards persons affected. Our findings underscore the importance of community education and behavior change as key to transforming perceptions and behavior towards persons affected.