Stigmatized Illnesses In Africa

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Abstract
THIS PAPER is an empirical documentation of an epidemiological approach for detecting stigmatised illness in a rural African community, without at the same time igniting the 'flame' of stigmatisation. A mobile team of public health professionals in Imo State of Nigeria in collaboration with the author, conduced a 'masked' health survey of a pilot area. The goal was to detect new cases of leprosy and tuberculosis which had been confined to their 'shell' on account of stigmatisation syndrome often associated with the two ailments. This goal was camouflaged in a spectrum of screening and other prophylactic measures while the outcome (new cases) was determined by blind assessment. An analysis of the outcome of the screening exercise performed on 7845 and 6468 villagers, screened for leprosy and tuberculosis respectively, resulted in an overall incidence of 2.0 and 2.2 new cases of leprosy and tuberculosis. This predicament was seen as being con founded in two 'mutable' variables, namely complacency on the part of the population at risk and inadequate surveillance on catchment areas by public health agencies. Suggestions advanced for improving control measures include a joint collaborative arrangement by the three-type authorities responsible for the three-sector battle against leprosy namely control measures, treatment of cases and rehabilitation of ex-lepers.

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