02823nas a2200289   4500000000100000008004100001260001900042653004200061653001800103653001500121653001200136100001700148700001100165700001100176700001300187700001300200700001300213700002000226700001500246700001800261245016800279856009800447300001100545490000700556520195600563022001402519       2026                            d  c09/2026bLepra10aHealth Knowledge, Attitudes, Practice10aSocial stigma10aBangladesh10aleprosy1 aChowdhury AS1 aSaha A1 aRoy JC1 aHaque TA1 aSarker M1 aRobin RC1 aDe Caux Bueno I1 aHinders DC1 avan Brakel WH00aGaps in leprosy knowledge and hidden stigma in northwest Bangladesh: a community-based mixed-method survey among patients, contacts, communities and health workers  uhttps://leprosyreview.org/admin/public/api/lepra/website/getDownload/6a901f13afaac162a437e502  a1 - 140 v973 a<p>Leprosy control requires early diagnosis, effective treatment and reduced stigma, yet community knowledge, attitudes and practices (KAP) in endemic settings remain poorly described. We assessed baseline leprosy-related KAP among key stakeholder groups in northwest Bangladesh. A community-based cross-sectional mixed-methods study was conducted in Nilphamari and Rangpur districts. We surveyed 900 respondents, including index patients, close contacts, community members and health care workers, using a KAP questionnaire (score 0–9; adequate knowledge ≥7) and analysed determinants with multivariable bootstrapped linear regression. Semi-structured interviews and focus group discussions explored explanatory models. Awareness of curability, multidrug therapy and non-contagiousness while on treatment exceeded 90% across groups, and most participants knew that disability can be prevented. Adequate knowledge was highest among health workers (89%), followed by persons affected (69%), contacts (67%) and community members (56%). Misconceptions about cause (heredity, unclean environment, supernatural or moral explanations) and transmission (skin contact, shared food) remained frequent. Higher education and being married consistently predicted better KAP, whereas older age and Grade 2 disability were associated with poorer scores among index patients. Qualitative findings showed coexistence of biomedical and religious or moral explanations and highlighted internalised stigma; 42.5% of patients preferred to conceal their diagnosis despite few reports of overt discrimination. In these high-endemic districts, core messages on curability and treatment have been absorbed, but knowledge gaps and hidden stigma persist among community members and vulnerable patient subgroups. Tailored, literacy-sensitive education and psychosocial support are needed to improve early detection, support post-exposure prophylaxis and reduce stigma.</p>
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