Self-care programmes for people living with leprosy: a scoping review

Objective Effective self-care is a key approach for the management and prevention of ulcers for people living with leprosy. Understanding the complexities related to the design and implementation of self-care interventions is key to improving future interventions. The aim of this scoping review is to synthesize the existing evidence on self-care for the prevention and management of ulcers amongst people living with leprosy. Methods We conducted a scoping review using PubMed, Web of Science and Infolep. Studies were included in the review if they reported on a self-care intervention and if they: (i) included individuals living with leprosy (ii) reported on leprosy specific selfcare activities (iii) reported on the development, implementation and evaluation of self-care programs. Results The initial search identified 476 articles from the three databases and 15 articles fulfilled our eligibility criteria. The self-care programs and interventions were conducted in eight low and middle-income countries. All interventions included were developed by 'organizing authorities' external to the community including governmental and non-governmental organizations. Interventions included education and training either directly with people living with leprosy or with health workers who implemented the intervention. Seven studies reported on clinical outcomes defined as reductions or healing of cracks, wounds or ulcers on hands and feet. A control group was only included in one study and the quality of intervention data varied greatly. Conclusion While this review suggests that self-care interventions for leprosy contribute to improved prevention and management of wounds, they must be interpreted with caution and additional research is needed.