Knowledge and attitudes to leprosy of Pacific People living in New Zealand

Leprosy persists in many Pacific countries, but attitudes and knowledge of leprosy among Pacific communities have not been well investigated. The lack of disease knowledge and stigma are major barriers to implementing case-finding strategies and prophylaxis programmes designed to eradicate leprosy. A survey of Pacific Island adults aged 18 years and older, and living in Christchurch, New Zealand (NZ) was conducted using a validated stigma assessment tool (EMIC score) and a questionnaire on knowledge of leprosy and acceptability of prophylaxis. A total of 117 Pacific adults (mean age 41, SD 14) completed the survey. Of these, 73% identified with Tongan ethnicity and 20% were NZ-born. The mean EMIC score was 18 (SD 9). Higher stigma scores were associated with older age, migrant status, Tongan ethnicity and those who knew someone with leprosy. The cause of leprosy was not known by 82% of participants, 74% perceived that leprosy was a very infectious disease, 82% thought that leprosy was a severe disease and 73% thought that leprosy was difficult to treat. Family members (82%) were identified as most at risk of contracting leprosy than close social contacts (26%) and neighbours (22·0%). Family members (93%) were a priority for prophylaxis followed by close social contacts (27%), neighbours (25%) and others (12%). Leprosy remains highly stigmatised among Pacific Islanders living in NZ which may increase the reluctance for offering prophylaxis to non-family contacts. This will contribute to the difficulty in eradicating leprosy by both case-finding and offering prophylaxis to contacts unless stigma can be reduced substantially.