Determinants of Diagnostic Delay in Leprosy Among Rural Populations: A Cross-Sectional Study from a Tertiary Care Centre

Abstract

Background: Leprosy remains a significant public health problem in rural India, where delayed diagnosis contributes to continued transmission, disability, and stigma. Early identification and treatment are essential for preventing deformities and reducing disease burden.

Objectives: To determine the magnitude of diagnostic delay in leprosy among rural patients and to identify socio-demographic, clinical, and healthcare-related determinants contributing to delayed diagnosis.

Methods: A hospital-based cross-sectional study was conducted at Mata Gujri Medical College, Kishanganj over 12 months. A total of 90 confirmed leprosy patients from rural areas were included. Diagnostic delay was defined as time from onset of symptoms to confirmed diagnosis. Data regarding socio-demographic profile, clinical presentation, healthcare-seeking behaviour, and knowledge about leprosy were collected using a structured questionnaire. Statistical analysis was performed using Chi-square test and logistic regression. A p-value <0.05 was considered statistically significant.

Results: The mean diagnostic delay was 9.8 ± 5.6 months. Delayed diagnosis (>6 months) was observed in 63.3% of patients. Factors significantly associated with delay included illiteracy (p=0.01), low socioeconomic status (p=0.02), initial consultation with traditional healers (p=0.004), lack of awareness of leprosy symptoms (p=0.001), and stigma-related concealment (p=0.03). Multibacillary leprosy was significantly more common among delayed cases (p=0.02).

Conclusion: A high proportion of rural leprosy patients experience diagnostic delay, primarily due to poor awareness, social stigma, and inappropriate initial healthcare contact. Strengthening community awareness and improving rural referral systems may reduce delay and disability burden.

Keywords: Leprosy; Diagnostic delay; Rural population; Stigma; Multibacillary leprosy; Health-seeking behaviour.