Comparative Analysis of Factors Affecting Disability Among Leprosy Patients Across Five Endemic Regions in Indonesia

Leprosy remains a public health challenge in several endemic regions of Indonesia, with varying degrees of disability and functional impairment. This study aimed to compare factors associated with WHO disability grade among leprosy patients across five endemic regions: Sitanala, Likupang, Lembata, Ambon, and Jayapura. A cross-sectional study was conducted using data from the KATAMATAKU program. Individuals diagnosed with leprosy were included. Demographic and clinical characteristics, World Health Organization (WHO) disability grade, functional limitation assessed with Screening of Activity Limitation and Safety Awareness (SALSA score), and participation restriction were assessed. Bivariate analyses were followed by multivariable analysis using generalized estimating equations (GEE), with region as the clustering variable. A sensitivity analysis excluding Sitanala and an ordinal logistic regression model with region as a fixed effect were performed. Among 580 participants, disability severity varied across regions. Longer disease duration was consistently associated with higher WHO disability grade (GEE aOR = 1.005; 95% CI: 1.002–1.007; p < 0.001). Higher SALSA score was associated with higher disability grade in the complete cohort (aOR = 1.096; 95% CI: 1.047–1.148; p < 0.001), but this association was not observed after excluding Sitanala. These findings highlight the importance of early detection and timely management to reduce disability progression among patients with leprosy.