02593nas a2200397   4500000000100000008004100001260001300042653001500055653001000070653000900080653002500089653001000114653002100124653002100145653001100166653002000177653001100197653001100208653002000219653001200239653000900251653001600260653001700276100001200293700001200305700001500317700001900332700001200351245017000363856004100533300000800574490000700582050001400589520157800603022001402181       1998                            d  c1998 Mar10aAdolescent10aAdult10aAged10aCase-Control Studies10aChild10aChild, Preschool10aDisabled Persons10aFemale10aHealth Services10aHumans10aInfant10aInfant, Newborn10aleprosy10aMale10aMiddle Aged10aTime Factors1 aBekri W1 aGebre S1 aMengiste A1 aSaunderson P R1 aZewge S00aDelay in presentation and start of treatment in leprosy patients: a case-control study of disabled and non-disabled patients in three different settings in Ethiopia.  uhttp://ila.ilsl.br/pdfs/v66n1a01.pdf  a1-90 v66  aBEKRI19983 a<p>The delay incurred by leprosy patients between the onset of symptoms and the start of treatment has not been well characterized. Because reducing this delay is likely to be the most productive of all activities aimed at preventing disability, we compared the various components of delay in disabled and nondisabled new leprosy cases in a case-control study. Disabled patients had a median overall delay of 26 months, while nondisabled patients incurred a delay of only 12 months. The total delay was divided into three components: a) the delay between the onset of symptoms and the first act of health-seeking behavior, which was significantly longer for disabled patients; b) the delay between the first action and the first visit to a recognized clinic, which was also significantly longer for disabled patients; and c) the delay between the first clinic visit and the start of treatment, which was important in some cases: in those patients whose delay was due to problems within the health services, disabled patients again had a significantly longer delay. The study also compared two rural areas of Ethiopia, one with high and one with low rates of disability in new cases. High rates of disability (and greater delay in starting treatment) were thus associated with high levels of stigma, being from the Christian rather than the Muslim community, and the use of traditional medicine. There was, surprisingly, no association with knowledge about the transmission, symptoms and curability of leprosy. Implications for health promotion activities are discussed.</p>  a0148-916X