Self-care interventions to reduce, prevent or monitor physical disability in those affected by leprosy: Protocol for a systematic review.

BACKGROUND: Leprosy, also known as Hansen's disease, is a chronic infectious neglected tropical disease. Leprosy can cause extensive immune mediated nerve damage which can persist post cure of infection with multidrug therapy, leaving a significant burden of physical disability among those affected by leprosy. Leprosy can also cause irreversible damage to the eyes and eventual blindness or visual disability. One means of preventing, monitoring and managing the disability as a result of leprosy is through self-care. Self-care is the practice of patients undertaking activities to improve or maintain their own health with or without the support of a healthcare professional, and has been a part of World Health Organization Zero leprosy strategies for many years. This review will seek to identify what self-care interventions exist for leprosy affected people and will map these interventions to the transtheoretical model of behaviour change to identify which level of the model current interventions target. Sub questions will explore what information is provided regarding the cost of the interventions and additionally explore what eye, feet and hand specific self-care advice is given by interventions. METHODS: We will search for literature in PubMed, Medline ALL, Web of science Core Collection, Embase, LILACS and SciELO. Studies that encompass a self-care intervention under the definition provided by the World Health Organization targeting those affected by leprosy will be eligible for inclusion. No language restriction will be applied. Data will first be deduplicated using endnote before the final deduplicated search results are uploaded to Rayyan for screening by the research team. We will apply a blinded screening whereby if at least one screener identifies a paper as potentially relevant it will proceed to full text screening, this will be carried out independently by at least two of the authors, in this case of disagreement a final decision will be made by the senior author. Quantitative, qualitative and mixed method studies will be eligible for inclusion. Studies will be assessed for bias using CASP checklists. Findings will be reported in narrative synthesis and as a visual representation of levels of the transtheoretical model addressed in interventions. Start date: 11 August 2025. End date: 30 November 2025. DISCUSSION: The findings from this review will document existing self-care interventions for those affected by leprosy, mapping the individual interventions to the stage of the transtheoretical model of behaviour change that they address. Information will also be presented regarding implementation costs of the interventions and what specific advice for hands, feet and eyes is given. Highlighting promising interventions can support clinicians in low-resource settings in advising their patients on what to prioritize in their self-care. PROSPERO REGISTRATION NO.: CRD42025649623.