Stigma in neurological diseases in the Tropics.

Stigma which has been defined as an “attribute that is deeply discrediting, and that reduces the bearer from a whole and usual person to a tainted, discounted, and inferior one”, arises from various sources and occurs in different forms. Stigma can be internalised or anticipated by the stigmatised person who accepts perceived exclusionary views of the society or who fears enacted stigma by the society on persons with a stigmatizing conditions. Lastly, stigma may be endorsed or accepted by the society. Stigma is associated with many neurological diseases globally, especially the neglected tropical diseases. Stigma develops within the background of rich and diversified cultural beliefs and traditions, where the population’s knowledge on chronic neurological conditions is usually limited. In this context, attitudes and practices are based largely on misconceptions and myths. Stigma has serious consequences on people affected by neglected neurological conditions and their families. It may be considered as the weakest link in the chain of disease diagnosis, treatment, prevention and eventual control or elimination. Stigma therefore constitutes a limiting factor to an acceptable quality of life for patients and the society. Various strategies have been suggested to fight stigma but this war is far from being won, although some battles have been successful. The brain mechanisms of stigma are largely unknown although some interesting data are now available. The growth of the young discipline of social neuroscience despite many challenges may provide leads on more effective strategies for stigma reduction in the future.