Pengaruh Stigma Sosial terhadap Kepatuhan Pengobatan dan Luaran Klinis Pasien Kusta di Indonesia: A Systematic Literature Review

Monika Rai Islamiah

doi:10.55606/innovation.v4i3.9574

Authors

Monika Rai Islamiah RSUD Palembang BARI

DOI:

https://doi.org/10.55606/innovation.v4i3.9574

Keywords:

Clinical Outcomes, Leprosy, Quality of Life, Social Stigma, Treatment Adherence

Abstract

Leprosy remains a significant public health problem in Indonesia, affecting not only physical health but also creating substantial social consequences through stigma. Social stigma may influence patients’ health behaviors, including treatment adherence and therapeutic outcomes. This study aimed to examine the influence of social stigma on treatment adherence and clinical outcomes among leprosy patients in Indonesia using a Systematic Literature Review (SLR) approach. Literature searches were conducted across several scientific databases, focusing on studies published between 2022 and 2026. The selection process followed predetermined inclusion and exclusion criteria, resulting in 30 eligible articles for analysis. The review found that social stigma contributes to poor treatment adherence, delayed health-seeking behavior, reduced quality of life, and increased risk of mental health problems among people affected by leprosy. Family support, community support, health education, self-care interventions, and healthcare worker involvement were identified as important factors in reducing stigma and improving treatment success. The findings highlight the need to integrate social and psychological interventions with medical services to enhance treatment adherence and clinical outcomes among leprosy patients in Indonesia.

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References

Ab Aziz, M. Z., Mohammad, W. M. Z. W., Gantul, V. J., & Mujin, S. M. (2026). Factors associated with incomplete treatment among leprosy patients in Sabah, Malaysia, between 2012 and 2016. Leprosy Review, 97(2), 0-0.

Alfitriani, A., Maliya, A., & Purwaningsih, H. (2017). Social stigma, adherence to medication, and motivation for healing among patients with leprosy. Belitung Nursing Journal, 3(5), 432–439.

Alio, A. P., Malam Mamane Sani, I., Abdou, Y., Gado, M., Harouna, I., & Celiktemur, B. (2025). Leprosy stigma in the healthcare setting: Lived experiences of persons affected by leprosy in Niger. PLoS Neglected Tropical Diseases, 19(10), e0013584.

Arudchelvam, U., Pulendran, T., Sirimanne, M., Pabasara, S., Kahawita, I., & Chandraratne, N. (2025). Stigma of People Affected by Leprosy and its determinants: a cross-sectional study in Sri Lanka. BMC Infectious Diseases, 25(1), 148.

Cruz, P. T., Miot, H. A., Talhari, C., Pedrosa, V. L., da Mata Serique, R., dos Santos Cordeiro, A. G., ... & Talhari, S. (2026). Stigma associated with leprosy among patients, contacts, and the general population in an endemic region of Brazil. Anais Brasileiros de Dermatologia, 101(2), 501301.

Fuady, A., Arifin, B., Yunita, F., Rauf, S., Fitriangga, A., Sugiharto, A., ... & Wingfield, T. (2024). Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study. PLOS Global Public Health, 4(1), e0002489.

Fuady, A., Arifin, B., Yunita, F., Rauf, S., Fitriangga, A., Sugiharto, A., ... & Wingfield, T. (2023). Stigma, Depression, Quality of Life, and the Need for Psychosocial Support Among People with Tuberculosis in Indonesia: A Cross-Sectional Multi-Site Study. Muchtaruddin and Wingfield, Tom, Stigma, Depression, Quality of Life, and the Need for Psychosocial Support Among People with Tuberculosis in Indonesia: A Cross-Sectional Multi-Site Study.

Gudipun, L. E. R., Limbu, R., & Nayoan, C. R. (2026). A qualitative case study on the resilience of leprosy patients facing community stigma in Sikka Regency, Indonesia. Psychology, Health & Medicine, 1-21.

Haerana, B. T., Sadarang, R. A. I., Bujawati, E., Adnan, Y., & Syarifuddin, N. (2025). Data-Based Evidence on the Causality Model of Social Stigma on Medication Compliance in Leprosy Patients in Bone District, Indonesia. Window of Health: Jurnal Kesehatan, 145-156.

Handika, D. O., Siswati, A. S., Sukoco, S. H., & Ahmad, R. A. (2026). Determinants of Health‐Seeking Behaviour for Leprosy Among High‐Risk Populations in Gunungkidul District, Indonesia: A Community‐Based Cross‐Sectional Study. Tropical Medicine & International Health, 31(3), 336-344.

Hannan, M., Hidayat, S., Suprayitno, E., Indriyani, R., & da Costa Fernandes, A. (2025). The Effect of Social Support on Self-Care Behavior of People with Leprosy in Madura Indonesia. Jurnal Keperawatan Global, 10(2).

Horota, M. E. (2026). Determinants of Compliance with Lawrence Green Theory-Based Leprosy Treatment in Leprosy Patients in Sarmi Regency, Papua Province. STRADA: Jurnal Ilmiah Kesehatan, 15(1), 11-17.

Kinanti, H., & Alinda, M. D. (2024). The impact of leprosy-related stigma and coping mechanisms of people affected: A qualitative study from a suburban area in Northern district of Gresik, Indonesia. Leprosy Review, 95(2), 0-0.

Limato, R., Sutrisni, I. A., Sagara, R., Abdillah, A. F., Yuliati, Y., Kadri, A., ... & Grijsen, M. L. (2025). Exploring leprosy perceptions in South Sulawesi, Indonesia: A mixed-methods study on knowledge, attitudes, practices, and stigma. PLOS Global Public Health, 5(12), e0005675.

Manoppo, M., Sukmana, O., & Yumitro, G. (2026). Social Stigma Against Patients with Infectious Diseases and Its Impact on Patient Mental Health. International Journal of Economics Management and Social Science, 9(1), 400-410.

Marpaung, Y. M., Ernawati, E., & Dwivania, A. T. (2022). Stigma towards leprosy across seven life domains in Indonesia: A qualitative systematic review. BMJ Open, 12(11), e061923. https://doi.org/10.1136/bmjopen-2022-061923

Masala, C. W., Haroen, H., & Pramukti, I. (2025). Community-Based Interventions for People Affected by Leprosy: A Narrative Review. Journal of Health and Nutrition Research, 4(2), 706-717.

Meadows, T., & Davey, G. (2022). What factors influence adherence and non-adherence to multi-drug therapy for the treatment of leprosy within the World Health Organisation South East Asia region? A systematic review. Leprosy Review, 93(4), 311-331.

Nasir, A., Yusuf, A., Listiawan, M. Y., & Makhfudli, M. (2022). The life experience of leprosy families in maintaining interaction patterns in the family to support healing in leprosy patients in Indonesian society. A phenomenological qualitative study. PLoS neglected tropical diseases, 16(4), e0010264.

Pepito, V. C. F., Loreche, A. M., Samontina, R. E. D., Abdon, S. J. A., Fuentes, D. N. L., & Saniel, O. P. (2023). Factors affecting treatment adherence among leprosy patients: Perceptions of healthcare providers. Heliyon, 9(7).

Pieter, Y., & Grijsen, M. L. (2022). Picturing health: the burden of leprosy in eastern Indonesia. The Lancet, 399(10335), 1588-1599.

Putri, A. I., de Sabbata, K., Agusni, R. I., Alinda, M. D., Darlong, J., de Barros, B., ... & Peters, R. M. (2022). Understanding leprosy reactions and the impact on the lives of people affected: An exploration in two leprosy endemic countries. PLoS neglected tropical diseases, 16(6), e0010476.

Putri, A. I., Peters, R. M., De Sabbata, K., Mengistu, B. S., Agusni, R. I., Alinda, M. D., ... & Zweekhorst, M. B. (2025). A socio-ecological model of the management of leprosy reactions in Indonesia and India using the experiences of affected individuals, family members and healthcare providers. BMC health services research, 25(1), 196.

Putri, W. J. K., Hapsari, Y., & Kusuma, D. R. (2024). Prevalence and health-seeking behavior of leprosy patients at Universitas Mataram Hospital. Berita Kedokteran Masyarakat, 40(5), e8777.

Rahayu, T., Friska, D., Sopamena, Y., Menaldi, S. L., Gibran, K., Dadun, ... & Irawati, Y. (2025). Validity and reliability of local endemic language version of the SARI Sigma Scale questionnaire for assessing stigma in leprosy patients. Frontiers in Public Health, 12, 1474745.

Sari, L. P. S. K., Karna, N. P. R. V., & Rusyati, L. M. M. (2025). The Effect of Health Education on Leprosy-Related Stigma Among Patients and Family Contacts at Prof. Dr. IGNG Ngoerah General Hospital: A Pre-and Post-Study. Jurnal Biomedika dan Kesehatan, 8(3).

Sari, L. P. S. K., Karna, N. P. R. V., Rusyati, L. M. M., Karmila, I. A. D., Puspawati, N. M. D., & Winaya, K. K. (2025). Health Education Impact on Leprosy-Related Stigma Among Patients and Contacts: A Pre-Post Study. Jurnal Biomedika dan Kesehatan, 8(3), 317-328.

Sastroamidjoyo, A. K., & Anshari, D. (2023). Stigma sosial dan kualitas hidup orang dengan kusta di Indonesia: Literature review. Media Publikasi Promosi Kesehatan Indonesia, 6(3), 428–435.

Srihartati, E. (2025). The Role of Community Health Workers in the Control and Management of Leprosy: A Scoping Review. National Journal of Community Medicine.

Susanto, T., Laras Ati, N. A., Rasni, H., Susumaningrum, L. A., Kurdi, F., & Lam, K. G. Leprosy Self-Care Health Management: Promising Intervention for Improving Quality of Life and Reducing Stigma Among People Affected by Leprosy in Rural Areas Indonesia. Hanny and Susumaningrum, Latifa Aini and Kurdi, Fahruddin and Lam, Kim Geok, Leprosy Self-Care Health Management: Promising Intervention for Improving Quality of Life and Reducing Stigma Among People Affected by Leprosy in Rural Areas Indonesia.

Umniyati, H., Zahroh, H., & Yuliwulandari, R. (2022). Determinant factors that affect the quality of life of people with leprosy in sumenep, Indonesia. Malaysian Journal of Public Health Medicine, 22(1), 146-153.

Wijaya, T. N. A., & Meiyanti, M. (2023). Analyzing factors of leprosy patients’ adherence to treatment in Sukasari Sub-district, Subang. JKKI: Jurnal Kedokteran dan Kesehatan Indonesia, 135-143.

World Health Organization. (2024). Global leprosy (Hansen disease) update 2023: Ending transmission and achieving zero leprosy. Geneva, Switzerland: World Health Organization.

Wulandari, R. D., Lestari, D. T., & Jauhar, M. (2026). Social Stigma As a Determinant Of Tuberculosis Treatment Adherence In Public Health Centers. Gaster, 24(1), 48-64.