The economic impact of leprosy: A systematic review

Introduction

Leprosy, when left untreated, often leads to visible impairments of the hands, feet, eyes and face. These impairments, in combination with leprosy-related stigma, limit daily activities and people’s physical ability to perform work-related tasks. Therefore, many people affected with leprosy experience difficulty in finding employment, reduction in earnings and fewer opportunities for education. Thus, leprosy may have a large economic impact on people affected by leprosy and their families. However, the economic burden of leprosy remains unclear, as the available evidence regarding the economic impact of leprosy has not been systematically reviewed.

Methods

A systematic literature review was performed regarding the economic impact of leprosy. The databases Pubmed, Scopus, Web of Science, Google Scholar and Infolep were searched using search strings with keywords such as ‘’leprosy’’, ‘’impact’’, ‘’economic’’ and ‘’costs’’. Studies were included describing the economic situation of people affected by leprosy and their families, as well as studies focusing on the experiences of leprosy-affected people regarding their employment and income generation.

Results

A total of 216 research papers were identified and of these, 31 met the inclusion criteria and were included in full-text analysis. Quantitative, qualitative and mixed methods studies were included, describing the costs of leprosy, employment levels, income loss and experiences of leprosy patients. These studies mentioned that the high costs of leprosy lead to income loss among families affected by leprosy. Moreover, visible impairments and stigma result in high unemployment levels among (ex-)leprosy patients.

Conclusions

The economic impact of leprosy is significant. People with leprosy and their families experience income loss and unemployment because of visible impairments, leprosy-related stigma and high costs of leprosy. Consequently, many people affected with leprosy live in poverty. Socio-economic rehabilitation, vocational education, self-care groups and stigma reduction could help to alleviate poverty among people affected with leprosy, thereby reducing leprosy-related disability.