Stigma, depression and quality of life among people affected by neglected tropical diseases in Nepal

Background: Stigma and poor mental health are important factors influencing the quality of life (QOL) of people with neglected tropical diseases (NTDs). This study examines the relationship between stigma, depression and QOL among people affected by leprosy and lymphatic filariasis (LF) in Nepal.Methods: A cross-sectional community-based survey was conducted among 102 NTD-affected persons (70 leprosy and 32 LF) using interview-administered questionnaires measuring the level of stigma (5-QSI-AP), symptoms of depression (PHQ-9) and QOL (WHOQOL-8). Three different regression models were developed, each using the ordinary least squares and Poisson regression to evaluate the association between stigma and QOL, depression and QOL, and stigma and depression.Results: The mean scores were 21.8 +/- 4.4 for QOL, 6.6 +/- 5.6 for depression and 3.0 +/- 2.8 for stigma. Almost 17% reported the prevalence of depression symptoms. Both stigma (beta=-0.65, p<0.001) and depression (beta=-0.32, p<0.001) were associated with lower scores for QOL, while there was a significant positive relationship between stigma and depression (beta=0.92, p<0.001). Similar results were obtained from the Poisson regression models.Conclusions: The study showed a considerable burden of depression, stigma and poor QOL among study participants with leprosy and LF in Nepal. A holistic package of care that addresses the physical, mental and psychological well-being of people with NTD is required.