“The mosquitoes that destroy your face”. Social impact of Cutaneous Leishmaniasis in South-eastern Morocco, A qualitative study

Bennis, Issam; Belaid, Loubna; Brouwere, Vincent De; Filali, Hind; Sahibi, Hamid; Boelaert, Marleen

doi:10.1371/journal.pone.0189906

Cited by 53 publications

(64 citation statements)

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“…However, the disability weights are defined using different approaches with regards to the expert panel composition, health state description, and valuation methods [ 14 , 15 ]. The specific stigma and psychosocial distress generated by a non-fatal condition are often overlooked [ 16 , 17 ], although the social impact of CL is potentially severe and has been well-documented [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

et al. 2018

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IntroductionCutaneous leishmaniasis (CL) is the most frequent form of leishmaniasis, with 0.7 to 1.2 million cases per year globally. However, the burden of CL is poorly documented in some regions. We carried out this review to synthesize knowledge on the epidemiological burden of CL in sub-Saharan Africa.MethodsWe systematically searched PubMed, CABI Global health, Africa Index Medicus databases for publications on CL and its burden. There were no restrictions on language/publication date. Case series with less than ten patients, species identification studies, reviews, non-human, and non-CL focused studies were excluded. Findings were extracted and described. The review was conducted following PRISMA guidelines; the protocol was registered in PROSPERO (42016036272).ResultsFrom 289 identified records, 54 met eligibility criteria and were included in the synthesis. CL was reported from 13 of the 48 sub-Saharan African countries (3 eastern, nine western and one from southern Africa). More than half of the records (30/54; 56%) were from western Africa, notably Senegal, Burkina Faso and Mali. All studies were observational: 29 were descriptive case series (total 13,257 cases), and 24 followed a cross-sectional design. The majority (78%) of the studies were carried out before the year 2000. Forty-two studies mentioned the parasite species, but was either assumed or attributed on the historical account. Regional differences in clinical manifestations were reported. We found high variability across methodologies, leading to difficulties to compare or combine data. The prevalence in hospital settings among suspected cases ranged between 0.1 and 14.2%. At the community level, CL prevalence varied widely between studies. Outbreaks of thousands of cases occurred in Ethiopia, Ghana, and Sudan. Polymorphism of CL in HIV-infected people is a concern. Key information gaps in CL burden here include population-based CL prevalence/incidence, risk factors, and its socio-economic burden.ConclusionThe evidence on CL epidemiology in sub-Saharan Africa is scanty. The CL frequency and severity are poorly identified. There is a need for population-based studies to define the CL burden better. Endemic countries should consider research and action to improve burden estimation and essential control measures including diagnosis and treatment capacity.

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Section: Introductionmentioning

confidence: 99%

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

et al. 2018

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“…A scoping review on the impact of localised cutaneous leishmaniasis on psychosocial wellbeing has recently been conducted. Eight quantitative studies (44,51–55,57,58) five qualitative studies (6,9,11,59,60) and two mixed-methods (10,61) studies were included in their review. It combines the results of the quantitative studies through narrative synthesis looking at anxiety and depression, low QoL, stigma and fear of scars.…”

Section: Resultsmentioning

confidence: 99%

“…Stigma, feelings of rejection and social exclusion are a few of the social consequences of CL and PKDL that are much more easily studied in a qualitative setting, e.g. in focus groups or individually using non-structured open-ended questionnaires as was the case with (10,11,69). Overall, the clinical manifestations for PKDL and CL both led to decreased body satisfaction as well as misconceptions within society about potential disease spread.…”

Section: Discussionmentioning

confidence: 99%

“…For example, in Afghanistan, the incorrect belief that the disease can be transmitted by human contact results in social exclusion that can range from not sharing utensils to severe physical and emotional isolation (10). In some cultures, women are considered unfit for marriage or are separated from their children when they have the disease(10,11). A study involving high school students in Morocco showed awareness of the stigma attached to CL with self-stigmatization including feelings of shame, embarrassment, depression, and self-contempt (6).…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Leishmaniasis on Mental Health and Psychosocial Well-being: A Systematic Review

Pires

Wright

Kaye

et al. 2019

Preprint

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19Background: Leishmaniasis is a neglected tropical parasitic disease endemic in South 20 Asia, East Africa, South America and the Middle East. It is associated with low 21 socioeconomic status (SES) and responsible for considerable mortality and morbidity. 22Reports suggest that patients with leishmaniasis may have a higher risk of mental illness 23 (MI), psychosocial morbidity (PM) and reduced quality of life (QoL), but this is not 24 well characterised. The aim of this study was to conduct a systematic review to assess 25 the reported impact of leishmaniasis on mental health and psychosocial wellbeing. 26Methods: A systematic review of the literature was carried out. Pre-specified criteria 27 were applied to identify publications including observational quantitative studies or 28 systematic reviews. Two reviewers screened all of the titles, abstracts and full-studies 29 and a third reviewer was consulted for disagreements. Data was extracted from papers 30 meeting the criteria and quality appraisal of the methods was performed using the 31 Newcastle-Ottowa Scale or the Risk of Bias in Systematic Review tool. 32Results: A total of 14 studies were identified from 12,517 records. Nine cross-sectional, 33 three case-control, one cohort study and one systematic review were included. Eleven 34 assessed MI outcomes and were measured with tools specifically designed for this; nine 35 measured PM and 12 measured QoL using validated measurement tools. Quality 36 appraisal of the studies showed that six were of good quality. Cutaneous leishmaniasis 37 and post kala-azar dermal leishmaniasis showed evidence of associated MI and PM 38 including depression, anxiety and stigma, while all forms of disease showed decreased 39 QoL. The findings were used to inform a proposed model and conceptual framework to 40 show the possible links between leishmaniasis and mental health outcomes. 3 41 Conclusion: There is evidence that leishmaniasis has an impact on MI, PM or QoL of 42 patients and their families and this occurs in all the main subtypes of the disease. There 43 are however large gaps in the evidence. Further research is required to understand the 44 full extent of this problem and its mechanistic basis. 45 46 AUTHOR SUMMARY 47 Leishmaniasis is a parasitic disease prevalent in many low-and middle-income countries 48 worldwide. In this study the authors looked for evidence as to whether leishmaniasis 49 affected the mental health and quality of life of patients. To conduct the review, a wide 50 search of the literature was conducted, where a total of 14 full articles were included 51 and analysed. It was found that different forms of leishmaniasis (visceral leishmaniasis, 52 cutaneous leishmaniasis and post kala-azar dermal leishmaniasis) do cause a significant 53 impact on patients' mental health and quality of life through societal factors such as 54 stigma, lack of knowledge, culture and low self-esteem among others. However, no 55 evidence of biological mechanisms was found linking leishmaniasis to mental i...

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“…The common factors shared among all CL endemic areas are high population densities and malnutrition, combined with poor sanitary facilities (Hotez et al, 2012 , 2014 ; Karimkhani et al, 2016 ). Aside from the economic burden caused by the morbidity of CL, the social stigmatization (Hurrell et al, 2016 ) and emotional burden due to the ulcers, especially among the inflicted women and children represent other important sequelae associated with the disease (Chahed et al, 2016 ; Bennis et al, 2017a , b ).…”

Section: Introductionmentioning

confidence: 99%

Biomarkers of Cutaneous Leishmaniasis

Bahrami

Harandi

Rafati

2018

Front. Cell. Infect. Microbiol.

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Cutaneous leishmaniasis (CL) is an immune-mediated skin pathology caused mainly by Leishmania (L.) major, Leishmania tropica, Leishmania braziliensis, L. mexicana, and L. amazonensis. The burden of CL in terms of morbidity and social stigmas are concentrated on certain developing countries in Asia, Africa, and South America. People with asymptomatic CL represent a large proportion of the infected individuals in the endemic areas who exhibit no lesion and can control the infection by as yet not fully understood mechanisms. Currently, there is no approved prophylactic control measure for CL. Discovery of biomarkers of CL infection and immunity can inform the development of more precise diagnostics tools as well as curative or preventive strategies to control CL. Herein, we provide a brief overview of the state-of-the-art for the biomarkers of CL with a special emphasis on the asymptomatic CL biomarkers. Among the identified CL biomarkers so far, direct biomarkers which indicate the actual presence of the infection as well as indirect biomarkers which reflect the host's reaction to the infection, such as alterations in delayed type hypersensitivity, T-cell subpopulations and cytokines, adenosine deaminase, and antibodies against the sand fly saliva proteins are discussed in detail. The future avenues such as the use of systems analysis to identify and characterize novel CL biomarkers are also discussed.

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“The mosquitoes that destroy your face”. Social impact of Cutaneous Leishmaniasis in South-eastern Morocco, A qualitative study

Cited by 53 publications

References 26 publications

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

Uncharted territory of the epidemiological burden of cutaneous leishmaniasis in sub-Saharan Africa—A systematic review

The Impact of Leishmaniasis on Mental Health and Psychosocial Well-being: A Systematic Review

Biomarkers of Cutaneous Leishmaniasis

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