The Correlation between Knowledge and Contact History with

Incidence of Leprosy in Bireuen District, Aceh, Indonesia

Kanna Inne Raisa

, Fitria Salim

and Safarianti

Faculty of Medicine, Syiah Kuala University

Faculty of Medicine, Syiah Kuala University / Dermatovenerology Department

Faculty of Medicine, Syiah Kuala University / Parasitology Department

Keywords:" Leprosy, Knowledge, Contact History

Abstract:" Leprosy is a chronic infectious diseases which has become a public health problem in Indonesia, including

at Bireuen District, Aceh Province. This study used observational analytic with a case control approach in

Bireuen District, Aceh Province. This study aims to analyze the correlation between knowledge about

leprosy, and contact history with leprosy patient with incidence of leprosy. The ratio of case and control was

1:1, with a total sample of 90 consisting of 45 cases and 45 controls. This study used total sampling in case

group and purposive sampling in control group. The data were analized with Mann-Whitney, Chi-square,

and logistic regression test. The logistic regression test results showed that the major constribution of the

transmission of leprosy were knowledge about leprosy (p=0,004; OR=9,699; 95% CI 2,072-45,404), and

contact history with leeprosy patient (p=0,006; OR=36,974; 95% CI 2,844-480,606). In conclusion, there

was a correlation between knowlegde and contact history with leprosy patient towards leprosy in Bireuen

District, Aceh Province.

1 INTRODUCTION

Leprosy is a chronic disease caused by

Mycobacterium leprae that attacks the skin,

peripheral nerves, upper respiratory mucosa, and

eyes. M. leprae develops slowly with the incubation

is about 5 years. Symptoms can occur within 1 year

and even up to 20 years after incubation (WHO,

2017).

According to official reports received from 138

countries from WHO (World Health Organization)

region was 176,176 cases (0.2 cases per 10,000

people) by the end of 2015 and globally reported

211,973 (2.9 new cases per 100,000 people)

(WHO,2017). In 2011, among the 17 countries that

had contribute leprosy patients in the world,

Indonesia as the third country with the highest

prevalence of leprosy patient after India and Brazil

(Ditjen PPM & PL P2 kusta,2012). In 2015 there

were 17,202 new case of leprosy reported in

Indonesia with 84.5% of Multi Basiler (MB) (Health

Ministry of The Republic of Indonesia, 2016).

Based on Indonesia Health Profile 2013, Aceh

Province is one of the provinces that has a high

prevalence of leprosy patients. Aceh was ranked the

9th highest number of leprosy patients in Indonesia

(Health Ministry of The Republic of Indonesia,

2015). Result of Situation Analysis of Leprosy

Eradication Program of Aceh Provincial Health

Office in 2016 shows three districts with highest

prevalence of leprosy in Aceh, which are North

Aceh, Pidie, and Bireuen as the third rank (Health

Office of Aceh Province, 2016).

The number of leprosy patients in Bireuen

District fluctuates every year. In January 2013 until

the end of March 2017 there were 170 cases of

leprosy spread in 16 health centers in Bireuen

District. Three working areas of health center in

Bireuen District with the highest prevalence of

leprosy from January 2013 to March 2017 are

Peusangan Health Center, Jeumpa Health Center,

and Kota Juang Health Center (Health Office of

Bireuen District, 2017).

There are many factors that cause leprosy, such

as age, sex, immunity factor, personal hygiene,

knowledge, economic status, contact history with

leprosy patients, occupancy density, and nutritional

status. Contact history is one factor of leprosy. A

person who had a contact history with a leprosy

patient has twice risk of suffering from leprosy than

someone who did not have a contact history with a

168

Raisa, K., Salim, F. and Safarianti, .

The Correlation between Knowledge and Contact History with Incidence of Leprosy in Bireuen District, Aceh, Indonesia.

DOI: 10.5220/0008788301680171

In Proceedings of the 2nd Syiah Kuala International Conference on Medicine and Health Sciences (SKIC-MHS 2018), pages 168-171

ISBN: 978-989-758-438-1

leprosy patient (Muharry A, 2013). This happened

because of the high intensity of someone" who had

direct contact with leprosy patients, making

transmission of leprosy easier.

The level of knowledge also has an important

correlation of the transmission of leprosy. A person

with low knowledge has 2.464 times greater risk

towards leprosy than a person with good knowledge

(Muharry A, 2013).

Research on factor analysis affecting leprosy in

Aceh, especially in Bireuen District has not been

studied previously. The highest number of leprosy

patients in the working area such as Peusangan,

Jeumpa and Kota Juang Community Health Center

of Bireuen District, made the researcher interested to

analyze the factors affecting leprosy in there. Factors

of knowledge about leprosy and contact history

with leprosy patient have a major contribution to the

transmission of leprosy, so the researchers chose

these factors to be studied the effect on leprosy.

2 RESEARCH METHODOLOGY

This research used analytic observational

methodology with case control approach. The

research data were collected in Peusangan, Jeumpa

and Kota Juang Community Health Center of

Bireuen District from November to December

2017. The samples in this study were patients who

were treated and lived in the Peusangan, Jeumpa

and Kota Juang Community Health Center Bireuen

District which were grouped into cases and controls.

The number of samples obtained is 45, with a ratio

of 1: 1 then the total number of case and control

samples is 90. In this study, the matching is age and

sex. The primary data consists of data were obtained

through questionnaire guided interview. Statistical

analysis for nominal scale using Chi-square, while

ordinal scale using Mann-Whitney, and multivariate

analysis using logistic regression.

3 RESULTS AND DISCUSSION OF

RESEARCH

Most leprosy cases were low knowledge as many as

25 respondents (100%). Unlike the control case,

most of them had good knowledge as many as 30

respondents (90.9%). Mann-Whitney test results

showed that there was a correlation between the

level of knowledge with incidence of leprosy (p =

0.000).

The correlation between knowledge with

incidence of leprosy can be seen in Table 1.

Table 1: Correlation of Knowledge about leprosy

with Incidence of Leprosy.

Knowledge

Leprosy

Non-

Leprosy

Total

Value

(%)

Low

(100)

0,000

Moderate

(53,1)

(46,9)

(100)

0,05

Good

(9,1)

(90,9)

(100)

The results of this study showed that the

respondents in leprosy case had a contact history

with leprosy patients as many as 25 respondents

(96.2%), while the respondents in control case that

had no contact history with leprosy patients as many

as 44 respondents (68.8% ).

Chi-square test results showed that there was a

significant correlation between the contact history

with leprosy (p = 0.000). The odd ratio (OR) was

55,000, explained that respondents who had a

contact history with leprosy patients are 55 times

more risk to develop leprosy than those who did not

have a contact history with leprosy patients. The

value of OR> 1 which means the contact history

with leprosy pastient is a risk factor for leprosy

(Table 2).

Table 2: Correlation of Contact history with

leprosy patient with incidence of Leprosy.

Contact

History

Leprosy

Lepro

Non-

Lepro

Value

(%)

None

(31,3)

(68,8)

0,000

55,0

6,958

434,7

Yes

(96,2)

(3,8)

0,05

Total

(50)

The Correlation between Knowledge and Contact History with Incidence of Leprosy in Bireuen District, Aceh, Indonesia

169

The factors were done multivariate analyzed by

logistic regression test. The results of the analysis of

these factors can be seen in Table 3.

Table 3: Test Results of Logistic Regression

Analysis.

Variable

Sig.

Exp

95% CI

(B)

Lower

Upper

Knowledge

0,004

9,699

2,072

45,404

Contact

History

0,006

36,974

2,844

480,606

Based on the final results of logistic regression

test showed that knowledge and contact history with

leprosy patient had a major constribution to the

transmission of leprosy.

3.1 Correlation between Knowledge with

Incidence of Leprosy

The result of logistic regression test showed that

knowledge level was leprosy risk factor (p = 0,004)

with OR = 9,699. A person with low knowledge

about leprosy has higher risk towards leprosy 10

times than someone with good knowledge about

leprosy. The low knowledge about leprosy causes

the ignorance of the transmission of leprosy, which

affects the isolation or alienation of leprosy patients

due to stigma. The respondents with low knowledge

also causes ignorance of the possible consequences

of leprosy if not treated adequately.

Based on field research, 62.2% of respondents do

not know that leprosy is caused by leprosy bacteria,

and 53.3% of respondents believe that leprosy is

caused by God's curse. The results of this study also

found that 85.6% of respondents argue that leprosy

is transmitted through food cooked by leprosy

patients, and as many as 66.7% of respondents stated

that leprosy is a hereditary disease. Most

respondents did not know that leprosy could be

cured with complete and regular medication, and

54.4% of respondents did not know that treatment

could break the chain of leprosy transmission. Low

knowledge about leprosy can lead to late detection

and treatment that can reduce efforts to prevent

transmission of leprosy to people around.

The results of this study are consistent with the

previous research which obtained the result that

there was a significant correlation between

knowledge and leprosy incidence. The level of

knowledge has a significant correlation with leprosy

because the higher knowledge of a person about

leprosy, the better the person's actions in preventing

leprosy (Ramadhani DS, 2013)

The results of this study are also reinforced by

previous studies which indicate that there was a

correlation of knowledge with leprosy (Curnelia IA,

2016). The higher knowledge and ability to think

someone will encourage the individual to make a

healthy lifestyle including disease prevention and

health care behavior (Notoatmodjo, 2003).

Education is an initial capital for the community

to gain knowledge and information. Education has

an important role to the level of knowledge. The

data obtained in this study states that most of the

respondents with primary and junior secondary

education have low knowledge. The higher a

person's level of knowledge, the easier it will be for

the person to receive and understand the information

(Martomijoyo, 2014).

3.2 Correlation between Contact History

with Leprosy Patient with

Incidence of Leprosy

The result of logistic regression test showed that

the contact history with leprosy patient was leprosy

risk factor (p = 0,006) with OR = 36,974. A person

who had a contact history with a leprosy patient has

higher risk towards leprosy up to 37 times than

someone who did not have a contact history with

leprosy patient.

The results of this study are in accordance with

existing theory that the transmission of M. Leprae is

alive and intact out of the body of the patient and

into the body of another person due to the tendency

of frequent and long contact (Ditjen PPM & PL P2

kusta,2012). Contact history has an important role as

a medium of transmission of leprosy. The existence

of family members or relatives who suffer from

leprosy, causes frequent intense closeness in the use

of goods that transmit M. leprae to healthy people.

The frequency of prolonged exposure increases the

high risk of contracting leprosy compared with

people who are rarely in contact with leprosy patient

(Susanti and Azam, 2016).

The result of the research in the field is known

that the case respondents before suffering from

leprosy have a contact history with leprosy patient

for more than 2 years, either with housemate or non

housemate like friends and neighbors. Respondents

who do not suffer from leprosy tend to have no

contact history with leprosy patients.

The results of this study are in accordance with

previous studies showing that there was a significant

correlation between contact history with leprosy

patient towards leprosy (Ramadhani DS, 2013).

Other literature also states that contact history was a

SKIC-MHS 2018 - The 2nd Syiah Kuala International Conference on Medicine and Health Sciences

170

risk factor for leprosy (Gustam TYP, 2017). A

contact history with a leprosy patient makes it

possible for transmission of M. leprae from an

infected person to a healthy person (Susanti Kurnia

Ningrum, 2016). The closer and longer a person

contacts with leprosy patients, the greater likelihood

of someone suffering from leprosy.

4 CONCLUSION

The conclusion based on the results of research is:

There was a correlation between the level of

knowledge and contact history with leprosy pastient

towards leprosy in Bireuen District, Aceh Province.

5 SUGGESTION

The suggestions of this research are:

1. Health Institutions such as Health Office are

expected to establish good cooperation between"

health institutions in both Bireuen District and

Aceh Province in improving the eradication of

leprosy. One of the activities that can be carried

out public education in general about leprosy.

2. The community is advised to actively follow the

counseling held by the health agency, especially

counseling about leprosy. People are also called

upon to improve personal hygiene to reduce the

risk of leprosy transmission.

3. Clinicians can provide adequate education to

leprosy patients and families about leprosy to

prevent transmission of widespread disease of

leprosy.

4. Researchers then expected to add other

variables that affect leprosy such as nutritional

status, history of BCG vaccination and

occupancy density.

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