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Impact of Leprosy Awareness Campaigns on Early Healthcare-Seeking for Skin Lesions among Adults in Nigeria

Abstract

Leprosy remains an important public health concern in Nigeria despite the availability of effective treatment and the potential for preventing disability through early diagnosis and appropriate management. The disease primarily affects the skin and peripheral nerves and may present with skin lesions, changes in sensation, numbness, weakness, or other neurological manifestations. Adults with suspicious skin lesions may delay seeking professional healthcare because of limited knowledge, stigma, fear of discrimination, misconceptions about leprosy transmission and treatment, cultural beliefs, financial constraints, and preference for traditional or self-treatment. Delayed healthcare-seeking may contribute to late diagnosis, increased risk of nerve damage and disability, and continued transmission within affected communities. Leprosy awareness campaigns provide an opportunity to improve public knowledge, reduce stigma, promote recognition of suspicious skin lesions, and encourage timely consultation with qualified healthcare providers. Against this background, this study investigates the impact of leprosy awareness campaigns on early healthcare-seeking for skin lesions among adults in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Social Ecological Model. The Health Belief Model explains how adults' perceptions of susceptibility to leprosy, perceived severity of the disease, perceived benefits of early healthcare-seeking, perceived barriers, self-efficacy, and cues to action may influence their decisions to seek care for suspicious skin lesions. Health Literacy Theory emphasizes adults' ability to obtain, understand, evaluate, and apply accurate information concerning leprosy symptoms, transmission, treatment, and available healthcare services. The Social Ecological Model emphasizes the influence of individual, family, community, healthcare, cultural, socioeconomic, and environmental factors on healthcare-seeking behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how leprosy awareness campaigns may influence early healthcare-seeking for skin lesions among adults in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adults aged 18 years and above residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible adults. Leprosy awareness campaigns will be assessed using indicators such as exposure to awareness activities, frequency and duration of campaigns, information on leprosy symptoms and skin manifestations, transmission, treatment availability, importance of early diagnosis, disability prevention, stigma reduction, myths and misconceptions, referral pathways, and sources of reliable leprosy information. Early healthcare-seeking for skin lesions will be assessed using indicators such as recognition of suspicious or persistent skin lesions, intention to seek professional healthcare, time between noticing a suspicious lesion and consulting a healthcare provider, use of appropriate healthcare facilities, avoidance of prolonged self-treatment, avoidance of inappropriate treatment from unqualified providers, compliance with referral recommendations, and follow-up after consultation. Data will be collected using structured questionnaires, standardized leprosy awareness and healthcare-seeking assessment tools, scenario-based questions, and healthcare records where ethically and practically accessible. Descriptive statistics will be used to summarize participants' demographic and socioeconomic characteristics, awareness levels, previous experiences with skin lesions, sources of health information, and healthcare-seeking practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of leprosy awareness campaigns on early healthcare-seeking for skin lesions. Where a quasi-experimental design is adopted, healthcare-seeking practices before and after the awareness intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that leprosy awareness campaigns have a significant positive impact on early healthcare-seeking for skin lesions among adults in Nigeria. Adults exposed to structured, evidence-based, culturally appropriate, and community-focused leprosy awareness campaigns are expected to demonstrate greater recognition of suspicious skin lesions and a higher likelihood of seeking professional healthcare promptly than adults without comparable exposure. Awareness may improve understanding of the early signs of leprosy, correct misconceptions about transmission and treatment, and emphasize that leprosy is treatable and that early diagnosis can help prevent complications and disability. Campaigns may also reduce stigma and encourage individuals to discuss persistent or suspicious skin changes with qualified healthcare professionals rather than relying solely on self-medication or traditional remedies. However, stigma, fear of discrimination, limited access to healthcare facilities, transportation and financial barriers, cultural beliefs, misinformation, low perceived susceptibility, and limited availability of trained healthcare personnel may reduce the effectiveness of awareness campaigns alone. The study therefore expects accessible, sustained, community-based, evidence-driven, and stigma-sensitive leprosy awareness campaigns, supported by effective referral and treatment services, to contribute significantly to earlier healthcare-seeking for suspicious skin lesions among adults in Nigeria. The study is expected to contribute to the literature on leprosy awareness, early healthcare-seeking, skin disease recognition, infectious disease prevention, stigma reduction, health education, health literacy, community health, primary healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Tuberculosis and Leprosy Control Programme, National Primary Health Care Development Agency, state ministries of health, primary healthcare centres, hospitals, dermatology and leprosy services, community health workers, traditional and community leaders, development partners, and policymakers regarding strategies for improving early detection of leprosy. The study will also provide evidence-based recommendations for strengthening community leprosy awareness campaigns, improving recognition of early skin manifestations, reducing stigma and misinformation, strengthening referral pathways, increasing access to appropriate diagnostic and treatment services, and developing sustainable community-based interventions that promote timely healthcare-seeking and early detection of leprosy across Nigeria.

Keywords: Leprosy awareness campaigns, early healthcare-seeking, skin lesions, leprosy, early detection, health education, stigma reduction, healthcare-seeking behaviour, primary healthcare, adults, Nigeria, public health.