Disabilities in leprosy--The new concepts.

The concept of disabilities has undergone changes in recent years and disability is no longer a mere physical dysfunction. It includes activity limitations, stigma, discrimination, and social participation restrictions. In addition to the presence of an illness or impairment, the understanding of disability now explores the relationship between disease/illness/impairment, the persons functioning within daily activities/social roles, and the social, cultural, and physical environments that enable or limit an individual's ability to participate fully in his or her community and daily lives. International Classification of Functioning Disability and Health (ICF) has recognized several dimensions of disability viz., body structure and function (and impairment thereof), activity (and activity restrictions) and participation (and participation restrictions). It also recognizes the role of physical and social environmental factors in affecting disability outcomes and has shifted the focus from the cause of disability to its effect, thereby emphasizing the role of the environment (physical, cultural, social, political) rather than focusing on disability as a 'medical' or 'biological' dysfunction. There is not much information available about these relationships in leprosy related disabilities. Studies are required in different patient groups having different socio-cultural background to develop a better understanding of these issues. Accordingly the need for services can be worked out for rehabilitation of the patients released from the treatment and "Cure".