BackgroundCutaneous Leishmaniasis (CL) is a parasitic skin disease, linked to poverty, and belonging to the group of Neglected Tropical Diseases. Depending on the severity, the type of lesions or scars, and the context, CL can lead to self- and social stigma influencing the quality of life and psychological well-being of the patient. This dimension is, however, little documented for the most common, localized form of cutaneous leishmaniasis (LCL).We aimed to describe the current knowledge on the psychological burden and the stigma related to LCL.MethodsThe population of interest for this scoping review are patients or their relatives with localized LCL or related scars.We searched the electronic databases PubMed, Web of Knowledge, PsycINFO, POPLINE, Cochrane Library, Science Direct, Global Health, and LILACS, for articles written in Arabic, English, French, Dutch, Portuguese, or Spanish, and published until the end of August 2017.ResultsFrom 2485 initial records, 15 papers met our inclusion criteria. Dermatology life quality index was the most frequent used scale to assess LCL psychological impact in quantitative studies. Six qualitative studies used individual interviews and/or focus groups discussions to explore the psychological and/or the social burden of this disease. Quantitative assessments using standard scales as well as qualitative research asserts that LCL is a source of psychological suffering, stigmatization, and decreased quality of life (QoL).ConclusionMost studies showed that LCL has a significant negative effect on the QoL and mental health. However, the fact that the psychosocial burden generated by LCL is time-dependent makes it hard to measure. We recommend to develop a more specific and validated assessment scale to appreciate the full burden of this disease and enhance comparability of findings.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5260-9) contains supplementary material, which is available to authorized users.

Recent surveys and sample collection have conWrmed the endemicity of Dermanyssus gallinae in poultry farming worldwide. The reduction in number and eYcacy of many acaricide products has accentuated the prevalence rates of this poultry ectoparasite observed more often in non intensive systems such as free-range, barns or backyards and more often in laying hens than in broiler birds. The lack of knowledge from producers and the utilisation of inadequate, ineVective or illegal chemicals in many countries have been responsible for the increase in infestation rates due to the spread of acaricide resistance. The costs for control methods and treatment are showing the tremendous economic impact of this ectoparasite on poultry meat and egg industries. This paper reviews the prevalence 1 C rates of this poultry pest in diVerent countries and for diVerent farming systems and the production parameters which could be linked to this pest proliferation.

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.

Recent surveys and sample collection have conWrmed the endemicity of Dermanyssus gallinae in poultry farming worldwide. The reduction in number and eYcacy of many acaricide products has accentuated the prevalence rates of this poultry ectoparasite observed more often in non intensive systems such as free-range, barns or backyards and more often in laying hens than in broiler birds. The lack of knowledge from producers and the utilisation of inadequate, ineVective or illegal chemicals in many countries have been responsible for the increase in infestation rates due to the spread of acaricide resistance. The costs for control methods and treatment are showing the tremendous economic impact of this ectoparasite on poultry meat and egg industries. This paper reviews the prevalence 1 C rates of this poultry pest in diVerent countries and for diVerent farming systems and the production parameters which could be linked to this pest proliferation.

ObjectiveTo document the psychosocial burden of Cutaneous Leishmaniasis (CL) in rural communities in Southeastern Morocco.MethodBetween March and April 2015, we conducted qualitative research in communities exposed to Leishmania major or L. tropica in Errachidia and Tinghir provinces. Twenty-eight focus groups discussions (FGDs) were realized, with a stratification by gender and tradition of medicine (users of folk versus professional medicine). Data were analyzed using content analysis.ResultsThis rural population most exposed to CL in Morocco lacks access to health care in general and clearly points out there are other major public health issues that need to be resolved. Nonetheless, respondents consider the impact of CL lesions and scars as important and similar to that of burn scar tissue. Young women with CL scars in the face are stigmatized and will often be rejected for marriage in these communities. People usually try a long list of folk remedies on the active lesions, but none was felt adequate. There was a clear demand for better treatment as well as for treatment of the scars.ConclusionsThe psycho-social impact of CL due to L.major and L.tropica is substantial, especially for young single women with facial scars. These generate social and self-stigma and diminish their marriage prospects. CL is well known, but not considered as a major health priority by these poor rural communities in South-eastern Morocco where gender discrimination is still an issue and access to basic health care is as neglected as CL. Early CL diagnosis and new treatment options with better skin outcomes are urgently needed.

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A previously developed competitive enzyme-linked immunosorbent assay (cELISA) based on a speciesspecific, broadly conserved, and tandemly repeated B-cell epitope within the C terminus of rhoptry-associated protein 1 of Babesia bovis was refined and validated for use internationally. Receiver operating characteristic analysis revealed an assay with a specificity and positive predictive value of 100% and a sensitivity of 91.1%, with various negative predictive values depending on the level of disease prevalence. The cELISA was distributed to four different laboratories, along with a reference set of 100 defined bovine sera, including knownpositive, known-negative, and field samples. Pairwise concordances among the four laboratories ranged from 94% to 88%. Analysis of variance of the resulting optical densities and a test of homogeneity indicated no significant difference among the laboratories. Overall, the cELISA appears to have the attributes necessary for international application.

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