Stigma, participation restriction and mental distress in patients affected by leprosy, cutaneous leishmaniasis and Chagas disease: a pilot study in two co-endemic regions of eastern Colombia

Gomez, L.J. Posso; Wijk, Robin van; Selm, Lena van; Rivera, Alberto; Barbosa, Martha C.; Parisi, Sandra; Brakel, Wim H. van; Arévalo, J. de J. Cañizares; Quintero, William; Waltz, Mitzi; Puchner, Karl Philipp

doi:10.1093/trstmh/trz132

Cited by 36 publications

(66 citation statements)

References 33 publications

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“…This attitude could most likely be a consequence of the high endemicity of CL and the chronicity of the associated lesions that result in dis guring scars. Such scars lead to serious psychological and social suffering including stigma, social exclusion and mental distress [4]. Overall, the participants involved in the current study had a negative attitude towards CL.…”

Section: Discussionmentioning

confidence: 86%

“…It usually presents as single or multiple nodules and ulcers on the skin [1]. Although CL is generally not fatal, clinical symptoms can lead to serious dis guring scars that lead to social stigmatisation and psychological suffering as well as nancial loss [4]. Cutaneous leishmaniasis is considered a neglected tropical disease in that policymakers and public health professionals are not making enough effort to control its prevalence [3].…”

Section: Introductionmentioning

confidence: 99%

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Knowledge and Attitude of the Local Community Towards Cutaneous Leishmaniasis in Rural Endemic Areas in Southwestern Yemen

Alhrazi¹,

Haouas²,

Al-Mekhlafi³

2020

Preprint

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BackgroundCutaneous leishmaniasis (CL), a historically neglected tropical disease, represents a significant public health problem in many endemic countries including Yemen. The ongoing armed conflict that started in March 2015 has had a negative impact on the entire healthcare system including infectious disease control programmes. Therefore, this cross-sectional study aimed to assess the knowledge and attitude towards CL among endemic communities in southwestern Yemen. MethodsFive hundred households in five areas of Shar’ab district of Taiz governorate were randomly selected to participate in a quantitative survey. A pretested structured questionnaire was used to collect information on the participants’ sociodemographic background and their knowledge and attitude towards CL and the sand fly vector.ResultsThe analysis was conducted on a final sample of 466 individuals. Although the participants were aware of CL, about three quarters (77.7%) of them had poor overall knowledge about disease transmission, clinical presentation, treatment and prevention. Interestingly, about half of the participants (49.1%) were able to differentiate sand flies from other flies and mosquitoes; however, only 14.8% of the participants knew about the role of the phlebotomine sand fly in the transmission of CL. Similarly, the participants had poor overall knowledge about sand fly breeding sites, biting time and control measures. Although 44% of the participants considered CL to be more dangerous than malaria, only 36.6% believed that CL can be prevented and 76.4% had a negative attitude towards the disease. Univariate and multivariate analyses showed that age and gender were the significant determinants of knowledge about CL and the sand fly vector among the studied population.Conclusion A poor level of knowledge about the different epidemiological aspects of CL was found among the rural population in Taiz. This factor, together with the major collapse of the healthcare infrastructure and the paralysis of health authorities since the beginning of the ongoing civil war in Yemen, may be contributing to the continued endemicity of CL in the area. Hence, health education on CL transmission and prevention should be provided to the targeted communities.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitude of the Local Community Towards Cutaneous Leishmaniasis in Rural Endemic Areas in Southwestern Yemen

Alhrazi¹,

Haouas²,

Al-Mekhlafi³

2020

Preprint

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“…This includes Buruli ulcers, cutaneous leishmaniasis, post-kala-azar dermal leishmaniasis, leprosy, lymphatic filariasis (lymphoedema and hydrocele), mycetoma, onchocerciasis, fungal infections, scabies, and yaws. sNTDs not only cause considerable disability and stigma, but also exacerbate poverty [ 4 - 6 ]. The integration of mapping, surveillance, clinical diagnosis, and management has only been achieved in a limited range of settings and disease groupings [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review

Carrión¹,

Robles²,

Solà-Morales³

et al. 2020

JMIR Mhealth Uhealth

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Background Neglected tropical diseases (NTDs) represent a diverse group of 20 communicable diseases that occur in tropical and subtropical areas in 149 countries, affecting over 1 billion people and costing developing economies billions of dollars every year. Within these diseases, those that present lesions on the skin surface are classified as skin NTDs (sNTDs). Mobile health interventions are currently being used worldwide to manage skin diseases and can be a good strategy in the epidemiological and clinical management of sNTDs. Objective We aimed to analyze existing evidence about mobile health interventions to control and manage sNTDs in low- and middle-income countries (LMICs) and make recommendations for what should be considered in future interventions. Methods A systematic review was conducted of the MEDLINE, Embase, and Scopus databases over 10 years up to April 30, 2020. All types of clinical studies were considered. Data were synthesized into evidence tables. Apps were selected through a comprehensive systematic search in the Google Play Store and Apple App Store conducted between March 20 and April 15, 2020. Results From 133 potentially relevant publications, 13 studies met our criteria (9.8%). These analyzed eight different interventions (three SMS text messaging interventions and five app interventions). Six of the 13 (46%) studies were community-based cross-sectional studies intended to epidemiologically map a specific disease, mainly lymphatic filariasis, but also cutaneous leishmaniasis, leprosy, and NTDs, as well as sNTDs in general. Most of the studies were considered to have a high (5/13, 39%) or moderate (4/13, 31%) risk of bias. Fifteen apps were identified in the Google Play Store, of which three were also in the Apple App Store. Most of the apps (11/15, 73%) were targeted at health care professionals, with only four targeted at patients. The apps focused on scabies (3/15, 20%), lymphatic filariasis (3/15, 20%), cutaneous leishmaniasis (1/15, 7%), leprosy (1/15, 7%), yaws and Buruli ulcer (1/15, 7%), tropical diseases including more than one sNTDs (3/15, 20%), and NTDs including sNTDs (2/15, 13%). Only 1 (7%) app focused on the clinical management of sNTDs. Conclusions All mobile health interventions that were identified face technological, legal, final user, and organizational issues. There was a remarkable heterogeneity among studies, and the majority had methodological limitations that leave considerable room for improvement. Based on existing evidence, eight recommendations have been made for future interventions.

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“… 4 Several NTDs, such as leishmaniasis, leprosy and lymphatic filariasis, cause facial and bodily changes, or ‘disfigurements’, that lead to pain and distress. 5 Exclusion due to physical and sensory impairments may also worsen mental health. 4 Perhaps most importantly, ‘stigma’ causes both exclusion and poor mental health.…”

mentioning

confidence: 99%

“…Stigma is often an overriding concern of people with NTDs, 5 , 6 due to the infectious nature of NTDs and consequent fear of contagion and the obvious physical signs that arise with certain conditions and are often considered unappealing. Stigma sounds simple but actually mixes a range of distinct concepts.…”

mentioning

confidence: 99%

Disability, mental health, stigma and discrimination and neglected tropical diseases

Kuper

2020

Transactions of the Royal Society of Tropical Medicine and Hygiene

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The neglected tropical disease (NTD) agenda should include a focus on disability when ‘planning for the next decade of progress’. Millions of people are currently living with the disabling consequences of NTDs and mental health conditions are frequent among people living with NTDs. Stigma around NTDs is also common. However, these aspects of NTDs are often ignored by programmes that focus on infectious disease control. NTD programmes must broaden in scope to include provision of rehabilitation and linkages to mental health support and tackling stigma through demystifying NTDs. These efforts will promote the inclusion and well-being of people living with NTDs.

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Stigma, participation restriction and mental distress in patients affected by leprosy, cutaneous leishmaniasis and Chagas disease: a pilot study in two co-endemic regions of eastern Colombia

Cited by 36 publications

References 33 publications

Knowledge and Attitude of the Local Community Towards Cutaneous Leishmaniasis in Rural Endemic Areas in Southwestern Yemen

Knowledge and Attitude of the Local Community Towards Cutaneous Leishmaniasis in Rural Endemic Areas in Southwestern Yemen

Mobile Health Strategies to Tackle Skin Neglected Tropical Diseases With Recommendations From Innovative Experiences: Systematic Review

Disability, mental health, stigma and discrimination and neglected tropical diseases

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