{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:57:48Z","timestamp":1791943068289,"version":"4.3.4"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010646","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T00:00:00Z","timestamp":1660867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006378","name":"Universitas Indonesia","doi-asserted-by":"publisher","award":["NKB-1325\/UN2.R3.1\/HKP.05.00\/2019"],"award-info":[{"award-number":["NKB-1325\/UN2.R3.1\/HKP.05.00\/2019"]}],"id":[{"id":"10.13039\/501100006378","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\nBackground<\/jats:title>\nLeprosy continues to be a health problem in Indonesia, with incidence reaching over 10,000 new cases by 2021. Leprosy-related disabilities cause limitation of patients\u2019 activity and participation in social activities. To date, no studies have been conducted in Indonesia which investigates disability in terms of bodily function, structure impairment, limitations in performing daily activities, and restrictions in participation in social activities in leprosy patients. This study is aimed to determine the demographic and clinical characteristics that might affect functional activity limitations of leprosy patients in endemic areas in Indonesia.<\/jats:p>\n<\/jats:sec>\n\nMethods and findings<\/jats:title>\nA cross-sectional study was conducted on 267 retrospectively-diagnosed cases of leprosy. The Screening of Activity Limitation and Safety Awareness (SALSA) scale was used to measure functional activity limitation, which comprises five domains: vision, mobility, self-care, work with hands, and dexterity. Differences among variables were evaluated using Kruskal-Wallis and Mann-Whitney test. The mean age of participants was 51.89\u00b113.66 years, the majority of which were men (62.5%), uneducated (48.3%), and classified as type 2 in the World Health Organization (WHO) disability grading for hands and feet (66.3% and 68.2%, respectively). Assessment using the SALSA Scale showed 28.5% of subjects were without limitation, 43.8% with mild limitation, 13.5% with moderate limitation, 9.4% with severe limitation, and 4.9% with extreme limitation. Significant differences in the total SALSA Scale were found between age groups (p = 0.014), educational level (p = 0.005), occupation (p<0.001), and WHO disability grades (p<0.001). Multivariate analysis showed that the most significant factor influencing the total score of SALSA was disability grading for feet (score = 0.31, p <0.001) followed by occupational status, disability grading for eyes, and age. Limitation of functional activity was significantly correlated to becoming unemployed with the odds 2.59.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nPeople affected by leprosy are prone to have functional activity limitation, especially the elderly, uneducated, unemployed and those with multiple disabilities. If they can overcome their barriers in functional activities, they will have better occupational opportunities.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010646","type":"journal-article","created":{"date-parts":[[2022,8,19]],"date-time":"2022-08-19T17:46:45Z","timestamp":1660931205000},"page":"e0010646","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Functional activity limitation of leprosy cases in an endemic area in Indonesia and recommendations for integrated participation program in society"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3687-1871","authenticated-orcid":true,"given":"Sri Linuwih","family":"Menaldi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Harini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelfidayani","family":"Nelfidayani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunia","family":"Irawati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Setiono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luh Karunia","family":"Wahyuni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tri","family":"Rahayu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gitalisa","family":"Andayani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dewi","family":"Friska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boya","family":"Nugraha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,19]]},"reference":[{"key":"pntd.0010646.ref001","first-page":"1","article-title":"Hapuskan sitgma dan diskriminasi terhadap kusta.","author":"RI Kementerian Kesehatan","year":"2018","journal-title":"InfoDATIN."},{"key":"pntd.0010646.ref002","unstructured":"WHO. Leprosy\u2014number of new leprosy cases data by country [Internet]. 2020 [cited 2021 Jul 16]. Available from: https:\/\/apps.who.int\/gho\/data\/node.main.A1639?lang=en"},{"issue":"1","key":"pntd.0010646.ref003","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s40249-020-00669-4","article-title":"Disability progression among leprosy patients released from treatment: a survival analysis.","volume":"9","author":"AR dos Santos","year":"2020","journal-title":"Infect Dis Poverty.Dec"},{"key":"pntd.0010646.ref004","unstructured":"World Health Organization, World Bank. Understanding disability. In: World report on disability 2011. Malta: WHO Library Cataloguing-in-Publication Data; 2011. p. 3."},{"key":"pntd.0010646.ref005","first-page":"35","volume-title":"Disabilities, rehabilitation and social problems in leprosy. In: WHO expert committee on leprosy: sixth report.","author":"J Grosset","year":"1988"},{"key":"pntd.0010646.ref006","first-page":"32","article-title":"Disability grades and quality of social relationships among people with leprosy in Donorojo leprosy rehabilitation village","volume":"3","author":"F Aishia","journal-title":"UI Proc Health Med"},{"key":"pntd.0010646.ref007","volume-title":"SALSA scale (Screening Activity Limitation and Safety Awareness) users manual version 1.1.","author":"The SALSA Collaborative Study Group.","year":"2010"},{"issue":"9","key":"pntd.0010646.ref008","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1080\/09638280600926587","article-title":"The development of a short questionnaire for screening of activity limitation and safety awareness (SALSA) in clients affected by leprosy or diabetes.","volume":"29","author":"The Salsa Collaborative Study Group, The Salsa Collaborative Study Group.","year":"2007","journal-title":"Disabil Rehabil."},{"key":"pntd.0010646.ref009","unstructured":"Hussmanns R. Defining and measuring informal employment [Internet]. Int Labour Organ; 2004. Available from: https:\/\/www.ilo.org\/public\/english\/bureau\/stat\/download\/papers\/meas.pdf"},{"key":"pntd.0010646.ref010","volume-title":"The informal sector and informal employment in Indonesia: country report 2010.","author":"Asian Development Bank, BPS-Statistics Indonesia","year":"2011"},{"key":"pntd.0010646.ref011","volume-title":"International Classification of Functioning, Disability and Health (ICIDH-2).","author":"Classification, Assessment, Surveys and Terminology Team.","year":"2001"},{"issue":"1","key":"pntd.0010646.ref012","doi-asserted-by":"crossref","first-page":"18394","DOI":"10.3402\/gha.v5i0.18394","article-title":"Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination.","volume":"5","author":"WH van Brakel","year":"2012","journal-title":"Glob Health Action."},{"issue":"1","key":"pntd.0010646.ref013","doi-asserted-by":"crossref","first-page":"e0009030","DOI":"10.1371\/journal.pntd.0009030","article-title":"Burden of depression and anxiety among leprosy affected and associated factors\u2014A cross sectional study from India.","volume":"15","author":"K Govindasamy","year":"2021","journal-title":"PLoS Negl Trop Dis."},{"issue":"3","key":"pntd.0010646.ref014","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1590\/abd1806-4841.20175216","article-title":"Limitation of activity and restriction of social participation in relation to age range, gender, and education in people with leprosy.","volume":"92","author":"BM Reis","year":"2017","journal-title":"An Bras Dermatol.Jun"},{"issue":"3","key":"pntd.0010646.ref015","doi-asserted-by":"crossref","first-page":"jrm00166","DOI":"10.2340\/16501977-2804","article-title":"Describing community-based rehabilitation services in Indonesia by using The International Classification of Service Organization in Rehabilitation 2.0.","volume":"53","author":"B Nugraha","year":"2021","journal-title":"J Rehabil Med"},{"issue":"7","key":"pntd.0010646.ref016","doi-asserted-by":"crossref","first-page":"e0003900","DOI":"10.1371\/journal.pntd.0003900","article-title":"Functional activity limitation and quality of life of leprosy cases in an endemic area in Northeastern Brazil.","volume":"9","author":"VS Santos","year":"2015","journal-title":"PLoS Negl Trop Dis."},{"issue":"9","key":"pntd.0010646.ref017","doi-asserted-by":"crossref","first-page":"e0008702","DOI":"10.1371\/journal.pntd.0008702","article-title":"Activity limitation and social participation restriction among leprosy patients in Boru Meda Hospital, Amhara Region, Ethiopia.","volume":"14","author":"SG Abdela","year":"2020","journal-title":"PLoS Negl Trop Dis."},{"key":"pntd.0010646.ref018","first-page":"1","article-title":"Characterization of the profession\/occupation of individuals affected by leprosy and the relationship with limitations in professional activities.","volume":"84","author":"S Nardi","year":"2012","journal-title":"Indian J Lepr."},{"issue":"1","key":"pntd.0010646.ref019","doi-asserted-by":"crossref","first-page":"78","DOI":"10.47276\/lr.90.1.78","article-title":"Knowledge and self-care practice of leprosy patients at ALERT hospital, Ethiopia.","volume":"90","author":"L Girma","year":"2019","journal-title":"Lepr Rev."},{"issue":"1","key":"pntd.0010646.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40249-020-00669-4","article-title":"Disability progression among leprosy patients released from treatment: A survival analysis.","volume":"9","author":"AR Dos Santos","year":"2020","journal-title":"Infect Dis Poverty."},{"key":"pntd.0010646.ref021","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.2147\/CIA.S140309","article-title":"Cognitive deficits and self-care behaviors in elderly adults with heart failure","volume":"12","author":"I Uchmanowicz","year":"2017","journal-title":"Clin Interv Aging"},{"issue":"1","key":"pntd.0010646.ref022","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1197\/j.jht.2004.10.011","article-title":"The impact of hand dominance and ulnar and median nerve impairment on strength and basic daily activities.","volume":"18","author":"P Rajan","year":"2005","journal-title":"J Hand Ther"},{"issue":"3","key":"pntd.0010646.ref023","doi-asserted-by":"crossref","first-page":"262","DOI":"10.47276\/lr.73.3.262","article-title":"Male-female (sex) differences in leprosy patients in south eastern Nigeria: females present late for diagnosis and treatment and have higher rates of deformity.","volume":"73","author":"E Peters","year":"2002","journal-title":"Lepr Rev"},{"issue":"1","key":"pntd.0010646.ref024","first-page":"85","article-title":"Knowledge and attitude of Nigerian physiotherapy students about leprosy.","volume":"16","author":"F Iyor","year":"2005","journal-title":"Asia Pac Disabil Rehabil J"},{"key":"pntd.0010646.ref025","article-title":"Perceived stigma of leprosy among community members and health care providers in Lalitpur district of Nepal: A qualitative study.","author":"SB Marahatta","year":"2018","journal-title":"PLoS ONE."},{"key":"pntd.0010646.ref026","doi-asserted-by":"crossref","first-page":"191","DOI":"10.47276\/lr.87.2.191","article-title":"Is the WHO disability grading system for leprosy related to the level of functional activity and social participation?","volume":"87","author":"VTC De Souza","year":"2016","journal-title":"Lepr Rev."},{"issue":"2","key":"pntd.0010646.ref027","doi-asserted-by":"crossref","first-page":"281","DOI":"10.7454\/ajce.v2i2.142","article-title":"Health care service for leprosy patients in Sitanala Tangerang (A proposed approach of comprehensive health care for Leprosy patient).","volume":"2","author":"Y Irawati","year":"2018","journal-title":"AJCE"},{"issue":"6","key":"pntd.0010646.ref028","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1038\/eye.2011.43","article-title":"The prevalence of ocular complications in leprosy patients seen in the United Kingdom over a period of 21 years.","volume":"25","author":"ANJ Malik","year":"2011","journal-title":"Eye"},{"issue":"1","key":"pntd.0010646.ref029","first-page":"12","article-title":"Impact of visual impairment on use of community support services by elderly persons: the blue mountains eye study.","volume":"40","author":"J Wang","year":"1999","journal-title":"IOVS"},{"issue":"1","key":"pntd.0010646.ref030","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/S0002-9394(99)00108-7","article-title":"Quality of life of low-vision patients and impact of low-vision services","volume":"128","author":"I Scott","year":"1999","journal-title":"Am J Ophthalmol"},{"issue":"10","key":"pntd.0010646.ref031","doi-asserted-by":"crossref","first-page":"e3000511","DOI":"10.1371\/journal.pbio.3000511","article-title":"Walking enhances peripheral visual processing in humans. Pack CC, editor","volume":"17","author":"L Cao","year":"2019","journal-title":"PLOS Biol"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0010646","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T00:00:00Z","timestamp":1662422400000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010646","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,6]],"date-time":"2022-09-06T17:53:43Z","timestamp":1662486823000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0010646"}},"subtitle":[],"editor":[{"given":"Carlos","family":"Franco-Paredes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,8,19]]},"references-count":31,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,19]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0010646","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0010646","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,19]]}}}