02766nas a2200289   4500000000100000008004100001260003700042653002400079653001300103653002100116653002600137100002000163700001600183700001200199700001600211700001300227700001900240700002500259700001500284700001500299245016000314856026000474300000900734490000700743520171200750022001402462       2025                            d  bPublic Library of Science (PLoS)10aLeprosy elimination10aBarriers10aLeprosy patients10aMedical professionals1 aMessa Carmona P1 aChaudhuri N1 aMora AB1 aPaniagua DZ1 aWillis M1 aSchlumberger F1 aOrtuño-Gutiérrez N1 aFastenau A1 aLambert SM00aBarriers to leprosy elimination in Bolivia: Exploring perspectives and experiences of medical professionals and leprosy patients–A phenomenological study  uhttps://www.researchgate.net/journal/PLOS-Neglected-Tropical-Diseases-1935-2735/publication/394435659_Barriers_to_leprosy_elimination_in_Bolivia_Exploring_perspectives_and_experiences_of_medical_professionals_and_leprosy_patients-A_phenomenological_study/  a1-170 v193 a<p>Background</p>

<p>Leprosy elimination has recently re-entered the global health sphere, with the World Health Organisation’s (WHO) “Towards zero leprosy” strategy (2021–2030). Previously, its elimination had been defined as a prevalence of less than 1 case per 10,000, which was achieved on a global scale in 2000, leading to a large withdrawal of resources from leprosy control and to neglect on both global and national scales. Despite this, leprosy continued to spread and affect hundreds of thousands of people annually.</p>

<p>Methods</p>

<p>The study explores the barriers to leprosy elimination in Bolivia, using a phenomenological approach, to discover the perceptions and experiences of leprosy patients and medical professionals regarding leprosy in Bolivia. It also explores the role of active case finding (ACF) for leprosy elimination in Bolivia. In-depth semi-structured interviews were conducted in Spanish, mainly at Jorochito Dermatological Hospital, the national referral centre for leprosy in Bolivia.</p>

<p>Results</p>

<p>Barriers to leprosy elimination in Bolivia are present at provider, patient, governmental, societal and community levels. These include poor health financing, untrained workforce, poor treatment adherence, centralised organisation of leprosy diagnosis and treatment and health illiteracy.</p>

<p>Conclusion</p>

<p>The barriers to leprosy elimination in Bolivia are complex, interconnected and embedded in Bolivian society. Leprosy elimination must be given priority on global and national scales to increase funding and importance, to continue ACF activities, and to promote national solutions for sustainable leprosy control.</p>
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