It is noticed that there are considerable number of lepromatous type leprosy patients -who are still bacteriologically positive even after having been treated with sulfone -drugs for 10 years or more at Sorokdo Leprosy Hospital, while other workers have reported that lepromatous type leprosy cases take 3 to 5 year periods to become bacteriologically negative.
There are many factors affecting the prognosis of leprosy and these factors can be considered in two catagories, firstly the medical factors and secondly the socio-medical factors.
The factors, not directly related to the medical science but to the social circumstances, are termed here in this study as the socio-medical factors. The medical factors affecting the prognosis of leprosy have well been investigated by many previous contributors.
The author has become greatly interested in the socio-medical factors rather than the medical factors, and the clarification of those socio-medical factors, if any, would greatly contribute to the treatment and rehabilitation of leprosy patients. Some 1,200 leprosy patients had been examined at random and among them 139 cases, not showing the negative conversion bacteriologically even after having received sulfone therapy for .10 years or more, were selected as the samples with poor prognosis, and 4,709 cases of all- the inpatients at Sorokdo Leprosy Hospital as the control group.
. In order to study the influences of the various socio-medical factors on the prognosis of leprosy, author analysed the factors of the samples with poor prognosis compared with those of the control group at Sorokdo Leprosy Hospital for 5 months from June 1 to Oct. 31, 1965.
The results are summarized as followings:
1. The samples with poor prognosis have been less educated than the control group.
Their lower level of education has made it difficult for the patients to apply their .ability to the solution of their deep disease-problems faithfully, and therefore it seems that the lower level of education has influence on the poor prognosis of leprosy.
2. The samples with poor prognosis have had their matrimonial lives less in number than those of the control group. The unmarried life which is abnormal for average men or women must have. many factors involved in it, but it may make the patient´s mentality low and affect the prognosis of leprosy.
3. The samples with poor prognosis have worse conceptions about the cause and the curability of their disease, leprosy, which may indicate the depression of the patients´ mentality and have influence on the poor prognosis of leprosy.
4. Most patients with poor progrnosis hope to live at Sorokdo Leprosy Hospital through their lives and not to be discharged from the Hospital for their social rehabilitations. Namely they are afraid of being discharged from the Hospital after negative conversion, which may indicate the. lower mentality of the patients and have influence on the poor prognosis of leprosy.
5. The samples with poor prognosis have severe deformity compared with the control group.
The deformity can be prevented to some extent by patient´s careful cautions, not to suffer from various traumas, burns or infections, but to apply physiotherapy and so on.
Both groups have had the opportunity to take the similar degree of education to prevent their deformities.
The advanced severity of deformities of the samples with poor prognosis indicates their unwillingness to understand the procedure of preventing deformities. and their carelessness to practice the preventive measures. These attitudes are considered to be due to their lower mentality compared with. that of the control group. And this lower mentality of the patients may have influence on the poor prognosis of leprosy.
6. Between the two groups, there are no differences among such factors as age and sex distributions, birth place, the age of onset, duration from onset to admission, duration of hospitalization, prevalence of pulmonary tuberculosis,. religion, occupation and level of living standard.
And all these factors seem to have no relations with the prognosis of leprosy.
With the results, it is to be stressed that an improvement or an enhancement of the socio-medical factors of a leprosy patient is greatly important to bring about a good. prognosis in the treatment of leprosy.
Although many medical factors are involved in the prognosis of leprosy, unless their socio-medical factors should be improved, a desirable prognosis of leprosy could not be achieved.
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