BackgroundIn Morocco, cutaneous leishmaniasis (CL) is usually known to be a slowly healing localized skin disease, but in some cases, it can lead to mutilating scars. The outbreak of CL due to Leishmania major in the Errachidia province in southeastern Morocco between 2008 and 2010 left many adolescents with permanent scar tissue on the face or other exposed body parts. We studied the psychosocial impact of CL on these young people.MethodsIn 2015 we conducted a cross-sectional survey among high-school students living in boarding schools in two CL-endemic areas of Errachidia: Rissani and Tinejdad. A self-administered questionnaire elicited responses about general knowledge of CL and related scars. An open-ended question focused on the possible psychosocial effects associated with these scars. The quantitative data were analyzed with Epi Info™ and the text data with NVivo software.ResultsAlmost 20% of 448 respondents reported they had experienced a CL lesion and 87% said it could possibly or definitely lead to psychological consequences. The text analysis showed that girls more often than boys expanded on the negative psychological effects of CL. The students considered CL as “dangerous”, “serious”, and “deathly”, and said it sometimes led to extreme suicidal ideations.ConclusionsThe burden of CL in this age group is not negligible. The indelible CL scars lead to self-stigma and social stigma, and the emergence of negative psychological effects in this age group. While some students accepted their CL scars and related suffering as their “destiny”, others were eagerly demanding protective measures against CL and treatment for the scars.Electronic supplementary materialThe online version of this article (doi:10.1186/s40249-017-0267-5) contains supplementary material, which is available to authorized users.

Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities’ perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints).The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people’s approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective.

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Teacher recommendations are an important factor in the process of track placement, but research has shown that they are biased by pupils’ social background. Pupils from higher socio‐economic backgrounds are more likely to get the advice to enrol in an academic track than pupils from lower socio‐economic backgrounds, irrespective of prior achievement. Previous studies looked primarily at individual pupil or parent characteristics and their influence on teacher recommendations. However, in this article, the authors argue that the class context forms the frame of reference within which a teacher forms his/her recommendation for pupils. Therefore, this article investigates class composition effects on teacher recommendations at the transition between primary and secondary education in Flanders. More specifically, we look at the socio‐economic, ethnic and ability composition of a class. Multilevel logistic models were tested on data collected in 36 primary schools in the cities of Ghent and Antwerp in May 2015. The results show that only the ability composition of the classroom exerts a frame‐of‐reference effect on teacher recommendations for academically versus practically oriented tracks. A pupil with a low individual ability in a low‐ability class was more likely to get the advice to enrol in an academically oriented track than an equally able pupil in a high‐ability class. This study demonstrated the limited importance of class composition in teacher recommendations, but calls for more research on teacher bias in the process of track assignment.