Pemanfaatan Kerangka ICF dan Pemetaan Disabilitas Berbasis DASH untuk Menilai Dampak Keterlambatan Diagnosis terhadap Disabilitas Fungsional pada Pasien Kusta di RSUD dr. Moewardi Surakarta

Abstract

Background: Leprosy remains a significant public health problem in Indonesia. Leprosy-related nerve damage produces impairment of body function and structure, activity limitation and participation restriction as conceptualised in the International Classification of Functioning, Disability and Health (ICF). Objective: To analyse the association between diagnostic and treatment delay and functional disability, interpreted within the ICF-WHO 2021 disability components. Methods: This was an analytic observational study with a cross-sectional design involving 20 leprosy patients recruited between November 2025 and January 2026. Functional disability was measured with the validated Indonesian version of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, whose items were linked to ICF body function, activity and participation codes. Associations were analysed using the Spearman rank correlation test, with the 95% confidence interval (CI). Results: Most patients were male (95%), with a mean age of 44.2 ± 13.7 years and a mean DASH score of 49.9 ± 21.1. Spearman analysis demonstrated a very strong positive correlation between delay and functional disability (rk = 0.802; 95% CI 0.547–0.921; p < 0.001). Mean DASH score increased progressively from 22.1 in patients treated within 6 months to 96.3 in those treated after more than 24 months. Conclusion: Delayed diagnosis and initiation of MDT are strongly associated with greater functional disability in leprosy patients. Because the analysis was bivariate in a single-centre sample of 20 multibacillary patients, and because DASH covers only part of the ICF framework and does not measure quality of life directly, these findings should be regarded as preliminary.