The Cutaneous Leishmaniasis and the Sand Fly: Knowledge and Beliefs of the Population in Central Morocco (El Hajeb)

Abstract

Background. Cutaneous leishmaniasis is a neglected parasitic dermal disease transmitted to humans through the bite of an infected female sand fly. Morocco hopes to eliminate all forms of leishmaniasis by 2030. These dermatoses pose a real public health problem in the country. Although the information is available on the disease, individual knowledge of cutaneous leishmaniasis and sand fly is not yet developed. Exploring people’s beliefs and popular behaviours about cutaneous leishmaniasis and its vector allows health officials to know the sociocultural aspects of the disease and to improve prevention and control actions. Objectives. To identify the knowledge of cutaneous leishmaniasis and its vector in the population in central Morocco. Methods. Based on the epidemiological data of leishmaniases in the province of El Hajeb, we conducted a field survey and personal interviews in April and May 2019, among 281 persons belonging to the localities where leishmaniases were registered. Results. Our results show that the participants use the concept of “Chniwla” (61.6%) for sand fly and the concept of “Hboub Chniwla” (50.8%) for cutaneous leishmaniasis; 24.6% of the respondents do not know how the disease is transmitted to humans and 43.7% use traditional treatments and home remedies to cure themselves. 44% of participants believe that sand fly does not transmit the disease to humans and only 6.4% were aware of their responsibility in vector control. Conclusions. The study concluded that there is a need to simplify the scientific terminology in the health education of citizens regarding these dermatoses and their vector by integrating the popular concepts obtained in this study to raise public awareness and facilitate their involvement as active actors in the prevention of cutaneous leishmaniasis.

Entomological Exploration of Sand Flies in Human Communities Affected by Cutaneous and Visceral Leishmaniasis in El Hajeb Province, Morocco

“…On the other hand, 24 species of sand flies have been described in Morocco, five of which are known for their vectorial capacities to transmit the leishmaniasis which represents a public health problem [ 6 , 22 ]. These species are (a) P. papatasi , the vector of CL major which is widespread in the south and southeast of the country [ 3 , 23 , 24 ], (b) P. sergenti which is responsible for the transmission of cutaneous leishmaniasis to L. tropica for which most of the recorded cases are reported in the center of the kingdom [ 24 , 25 ], and (c) the other three species are P. perniciosus , P. ariasi, and P. longicuspis which have been proven as vectors of severe forms of the disease, especially VL for which most cases have been reported in the north [ 3 , 26 ].…”

“…Beyond this clinical and parasitic variety of leishmaniasis, their common point is that they are transmitted in natural conditions by the bite of different species of infected female sand flies [ 1 ]. These insects are called “ Chniwla ” in most regions in Morocco [ 6 – 8 ].…”

Assessment of knowledge and perceptions on leishmaniasis: An island-wide study in Sri Lanka

“…Moreover, a very high proportion of study participants knew the symptoms of the disease correctly and believed the disease is curable indicating a satisfactory level of basic knowledge of the disease in the community, compared to the knowledge level of many other countries where knowledge on origin of the disease, transmission method etc. are very poor [ 15 – 18 ].…”

“…This is evident from the low percentages of individuals who gave incorrect answers to the questions (most of the individuals either gave the correct answer or acknowledged that they do not know the answer). This will be a plus point when conveying the correct information to these communities as most of the individuals will not bear misinformation or beliefs regarding the disease or the vector, which are often difficult to change when such views are embedded in communities [ 18 ].…”

Design and evaluation of two educational media in the form of animation and games to promote the cutaneous leishmaniasis prevention behaviors in adolescent female

“…Difficult treatment, high medical costs, drug resistance, drug side effects, long-term wounds, the possibility of secondary infection, and unpleasant scar formation are some of the problems associated with this disease [5]. Therefore, it is necessary to prevent CL, but there are no safe and effective vaccines for this purpose [6] and educating people at risk to protect themselves from sandfly bites is believed to be one of the best methods [7].…”