Utilization of the ICF Framework and DASH-Based Disability Mapping to Assess the Impact of Diagnostic Delay on Functional Disability among Leprosy Patients at dr. Moewardi General Hospital, Surakarta / Pemanfaatan Kerangka ICF dan Pemetaan Disabilitas Berbasis DASH untuk Menilai Dampak Keterlambatan Diagnosis terhadap Disabilitas Fungsional pada Pasien Kusta di RSUD dr. Moewardi Surakarta

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.

Latar Belakang: Kusta masih menjadi masalah kesehatan masyarakat di Indonesia Kerusakan saraf akibat kusta menimbulkan hendaya fungsi dan struktur tubuh, keterbatasan aktivitas serta pembatasan partisipasi sebagaimana dikonsepkan dalam International Classification of Functioning, Disability and Health (ICF). Tujuan: Menganalisis hubungan antara keterlambatan diagnosis dan pengobatan dengan disabilitas fungsional yang diinterpretasikan dalam komponen disabilitas ICF-WHO 2021. Metode: Studi observasional analitik desain cross-sectional pada 20 pasien kusta direkrut pada November 2025 - Januari 2026. Disabilitas fungsional dinilai menggunakan kuesioner Disabilities of the Arm, Shoulder and Hand (DASH) versi bahasa Indonesia yang tervalidasi dan setiap kelompok itemnya dipetakan ke kode ICF fungsi tubuh, aktivitas serta partisipasi. Hubungan antar variabel dianalisis dengan uji korelasi Spearman Rank dan interval kepercayaan 95% (IK95%). Hasil: Sebagian besar pasien berjenis kelamin laki-laki (95%) dengan rerata usia 44,2 ± 13,7 tahun dan rerata skor DASH 49,9 ± 21,1. Analisis Spearman menunjukkan korelasi positif yang sangat kuat antara keterlambatan dengan disabilitas fungsional (rk = 0,802; IK95% 0,547-0,921; p < 0,001). Rerata skor DASH meningkat progresif dari 22,1 pada keterlambatan kurang dari 6 bulan menjadi 96,3 pada keterlambatan lebih dari 24 bulan. Simpulan: Keterlambatan diagnosis dan inisiasi MDT berhubungan kuat dengan disabilitas fungsional yang lebih berat pada pasien kusta. Karena analisis bersifat bivariat pada 20 pasien multibasiler di satu pusat rujukan dan kuesioner DASH hanya mencakup sebagian kerangka ICF serta tidak mengukur kualitas hidup secara langsung, temuan ini bersifat pendahuluan.