关键词: 麻风, 因病致贫, 生存分析, Cox模型

Abstract: Objective: To evaluate the incidence and influencing factors of poverty caused by leprosy among patients in Shiyan Leprosy Prevention and Treatment Center from 2013 to 2022. Methods: A cohort study was conducted among 80 leprosy patients registered and managed from January 1, 2013 to December 31, 2022. The diagnosis date was taken as the starting point. Poverty caused by disease was defined as: average monthly additional economic burden ＞ 0 CNY (calculated from diagnosis to the end of follow-up), and the impact on family life ≥ moderate (Likert 5 level scale, score ≥ 3). The cumulative nonpoverty survival curve was plotted by KaplanMeier method, univariate analysis was performed using Logrank test, and Cox proportional hazards model was used to analyze risk factors for poverty. Results: The median follow up time of the whole cohort was 4.8 years, and the 10-year cumulative poverty rate was 77.3%. Multivariate Cox analysis showed that the risk of poverty in patients with grade 2 disability was 2.04 times that of patients without disability (HR=2.04, 95% CI: 1.9-8.9); the risk in elderly patients (≥60 years old) was 3.2 times that in the younger group (HR=3.2, 95% CI: 1.5-6.8). At baseline (time of leprosy diagnosis), 76% (61/80) of patients reported experiencing discrimination. The average annual income loss in the discriminated group (12 700 CNY) was significantly higher than that in the nondiscriminated group . Patients had a low score in mental health (2.1±0.9). Conclusion: Leprosy patients in Shiyan area have a high risk of poverty. Disability and advanced age are independent risk factors. It is suggested to strengthen early screening for disability, improve medical insurance coverage, and integrate social support to reduce the poverty rate.

Key words: leprosy, poverty caused by disease, survival analysis, Cox model