Motives and determinants for residence change after leprosy diagnosis, central Brazi

Abstract

Objective: To determine the extent of population movement after diagnosis with leprosy and to describe the underlying motives and determinants for relocation. Design: Ac ross-sectional study was conducted among those newly diagnosed with leprosy in 79 endemic municipalities in the state of Tocantins, central Brazil. Individuals were identified through the National Information System for Notifiable Diseases (SINAN) database and interviewed with structured questionnaires. Results: In total, 224 (20 ·9%) out of 1070 individuals relocated after their diagnosis with leprosy. Respondents moved to another neighbourhood in the same municipality ( n ¼ 178, 79 ·5%), followed by another municipality in Tocantins state ( n ¼ 26, 11 ·6%) and in another state ( n ¼ 11, 4· 9%). The primary motives and/or determinants for relocation were: home ownership ( n ¼ 55, 28 ·4%), familial reasons ( n ¼ 43, 19 ·2%), to seek better living conditions ( n ¼ 27, 13 ·9%), employment ( n ¼ 26, 11 ·6%), and better neighbourhood ( n ¼ 22, 9· 8%). Other motives were related to better access to leprosy diagnosis/treatment ( n ¼ 11, 4· 9%), owner-terminated rental ( n ¼ 5, 2· 2%), personal finances/could not afford housing ( n ¼ 4, 1· 8%). Perceived stigma due to leprosy was mentioned by one participant (0 ·5%). Conclusion: In Tocantins state, population movement is lower among individuals recently diagnosed with leprosy, as compared to the overall population. The primary motives for relocation after leprosy diagnosis were related to lifestyle changes. Stigma and treatment-related reasons did not appear to be common motives for population movement. These results may reflect policy changes instituted from the Brazilian Program of Leprosy Control to decentralise leprosy services and intensify health education campaigns within ab roader concept of Information, Education and Communication.