“A life of disclosure: stigma, discrimination, and homelessness.” A case study of a factor that slowed (or contributed to the slowed) treatment-seeking behaviour of a leprosy patient in Nepal

Nepal achieved leprosy elimination status in 2009 at the national level, but the disease burden present at the subnational level. Leprosy is frequently associated with stigma and discrimination even after infected persons have completed the treatment course due to visible deformities and disabilities, along with physical, economic, and psychological consequences. The fear of discrimination that people affected by leprosy face might cause them not to seek treatment.

We present the case of a 46-year-old man who stopped taking multidrug therapy 7 years ago due to anticipated stigma. He tried to hide the condition until it worsened: after disclosing his status, he found himself completely and utterly alone in life. The case contributes to an understanding of the burden of leprosy through the experience of the patient and encourages fellow clinicians to view the disease with a high level of suspicion even though it has been being tagged as eliminated at the national level.