Effects of impairments on activities and participation in people affected by leprosy in The Netherlands.

OBJECTIVE To assess the prevalence of impairments and evaluate the relationships between impairments, activity limitations and participation restrictions in people affected by leprosy living in The Netherlands. DESIGN A cross-sectional study. SUBJECTS Eighty-two people affected by leprosy living in The Netherlands. METHODS A postal questionnaire was performed. Impairments were inventoried with the Total Impairment Score. Activity limitations were assessed with the World Health Organization Disability Schedule II (WHODAS-II) and participation restrictions with the Impact on Participation and Autonomy (IPA) questionnaire. RESULTS A high prevalence of impairments was found (83%), mostly in hands and feet. Activity limitations were substantial, and highest for the WHODAS-II domains "household/work" and "getting around". The severity of impairments correlated significantly with activity limitations. Eye and foot impairments independently contributed to the domains "household/work" and "getting around", explaining 34% and 40% of variance. Poor or very poor participation (IPA) was reported by 13-32% of persons, mostly in the "autonomy outdoors" and "family role" domains. These domains were associated with activity limitations and hand impairments CONCLUSIONS People affected by leprosy in The Netherlands encounter limitations in activities and participation restrictions, which are related to the severity of impairments. The high prevalence of disability suggests rehabilitation care should be considered for a substantial proportion of people affected by leprosy.