Jessica Michgelsen, Ruth M. H. Peters, Wim H. Van Brakel, & Irwanto
Objective: Leprosy-related stigma varies in intensity in different contexts, yet it seems that no research has been conducted on the differences in the level of stigma within a specific area at geographical level. The aim of this study is to determine differences in leprosy-related stigma between 30 sub-districts in Cirebon District. Methods: Data were retrieved from the SARI Project. Two stigma assessment tools were used for leprosy-affected people (P-scale and SSS) and two for unaffected people (EMIC-CSS and SDS). Differences in median scores were analysed using a Kruskal-Wallis H test, and maps of the median scores per sub-district were created. Results: Significant differences were found between specific sub-districts in the EMIC-CSS, P-scale and SSS-scores. The highest median scores of stigma scores for both affected and unaffected participants were reported in the sub-district Waled (SSS: 29·9, P-scale: 19·5, EMIC-CSS: 19·2, SDS: 13·2), but participants from Astanajapura scored higher on the EMIC-CSS (19·7). Low median scores were found in Weru (respectively 7·7, 4·9, 7·0, 7·3). Furthermore, stigma scores in Eastern subdistricts were significantly higher than in Western sub-districts (p , 0·001). Conclusions: This study showed significant differences in leprosy-related stigma between East and West Cirebon, and various sub-districts. The data from the different instruments used showed a strong concordance. More research is needed to examine the underlying mechanisms for the differences in Cirebon District and to identify differences in other areas. The findings of this study are relevant for policymakers, health service managers and researchers.