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Gutiérrez JD, Ávila-Jiménez J, Altamiranda-Saavedra M. Causal association between environmental variables and the excess cases of cutaneous leishmaniasis in Colombia: are we looking to the wrong side? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02723-4. [PMID: 38884797 DOI: 10.1007/s00484-024-02723-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/15/2024] [Accepted: 06/07/2024] [Indexed: 06/18/2024]
Abstract
Our main aim was to estimate and compare the effects of six environmental variables (air temperature, soil temperature, rainfall, runoff, soil moisture, and the enhanced vegetation index) on excess cases of cutaneous leishmaniasis in Colombia. We used epidemiological data from the Colombian Public Health Surveillance System (January 2007 to December 2019). Environmental data were obtained from remote sensing sources including the National Oceanic and Atmospheric Administration, the Global Land Data Assimilation System (GLDAS), and the Moderate Resolution Imaging Spectroradiometer. Data on population were obtained from the TerriData dataset. We implemented a causal inference approach using a machine learning algorithm to estimate the causal association of the environmental variables on the monthly occurrence of excess cases of cutaneous leishmaniasis. The results showed that the largest causal association corresponded to soil moisture with a lag of 3 months, with an average increase of 8.0% (95% confidence interval [CI] 7.7-8.3%) in the occurrence of excess cases. The temperature-related variables (air temperature and soil temperature) had a positive causal effect on the excess cases of cutaneous leishmaniasis. It is noteworthy that rainfall did not have a statistically significant causal effect. This information could potentially help to monitor and control cutaneous leishmaniasis in Colombia, providing estimates of causal effects using remote sensor variables.
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Affiliation(s)
- Juan David Gutiérrez
- Universidad de Santander, Facultad de Ciencias Médicas y de la Salud, Instituto Masira, Bucaramanga, Santander, Colombia.
| | - Julián Ávila-Jiménez
- Maestría en Ciencias Biológicas. Universidad Pedagógica y Tecnológica de Colombia, Tunja, Boyacá, Colombia
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Al-Ashwal MA, Al-Adhroey AH, Atroosh WM, Alshoteri SA, Al-Subbary AA, Alharazi TH, Sady H, Azzani M, Lau YL, Al-Mekhlafi HM. Knowledge, attitude, practices and treatment-seeking behaviour concerning cutaneous leishmaniasis among rural hyperendemic communities in western Yemen. Sci Rep 2024; 14:12662. [PMID: 38830983 PMCID: PMC11148075 DOI: 10.1038/s41598-024-63526-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/29/2024] [Indexed: 06/05/2024] Open
Abstract
Cutaneous leishmaniasis (CL), a neglected tropical disease (NTD), is a major public health problem in Yemen with widespread distribution in rural areas. Evaluating the knowledge and understanding of people's beliefs towards the disease is essential to the implementation of effective control measures. This study aims to assess the knowledge, attitudes, practices (KAP) and treatment-seeking behaviour concerning CL among rural populations in the western highlands of Yemen. A community-based cross-sectional study was conducted among 289 household heads in four rural areas of the Utmah District. Data were collected using a pre-tested questionnaire. All the participants had heard about the disease; however, only 9.3% attributed it to sandflies. Nearly half (48.1%) of the participants could not mention any preventive measures for CL, and nearly two-thirds (65.4%) could not do so for sandflies. The overall 'good' knowledge about CL was found to be 51.2%, and it was 33.9% for sandflies. The participants' attitude and prevention practices towards CL were not satisfactory, as only 38.1% and 16.3% had a positive attitude and good CL-related prevention practices, respectively. Moreover, 45.7% believed CL to be a stigmatising disease, and 50% had used traditional remedies to treat suspected CL lesions. Multivariate analyses showed that age, sex, presence of CL-confirmed cases in the same household, residency, occupation and monthly household income were the significant predictors associated with KAP concerning CL among the participants. The findings support an urgent need for integrated health education and community mobilisation interventions to improve awareness of these vulnerable populations about this devastating disease.
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Affiliation(s)
- Manal A Al-Ashwal
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Abdulelah H Al-Adhroey
- Department of Community Medicine, Faculty of Medicine, Thamar University, Dhamar, Yemen.
| | - Wahib M Atroosh
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | - Sheikh Abdulhafed Alshoteri
- Department of Microbiology and Parasitology, Faculty of Medicine and Health Sciences, University of Aden, Aden, Yemen
| | | | - Talal H Alharazi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia
- Department of Medical Parasitology, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Hany Sady
- Centre for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Meram Azzani
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, 47000, Sungai Buloh, Selangor, Malaysia
| | - Yee-Ling Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
| | - Hesham M Al-Mekhlafi
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia
- Department of Epidemiology, Faculty of Public Health and Tropical Medicine, Jazan University, 45142, Jazan, Saudi Arabia
- Department of Parasitology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
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Bibi S, Kamran M, Ahmad H, Bibi K, Naqvi SKUH, Zuo Q, Shah NA, Cao J. Knowledge, Attitudes and Practices Regarding Taeniasis in Pakistan. Diseases 2023; 11:95. [PMID: 37489447 PMCID: PMC10366766 DOI: 10.3390/diseases11030095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/26/2023] Open
Abstract
Taeniasis is a neglected zoonotic disease responsible for serious health disorders, such as seizures, and may even cause death. Humans are the definitive host for the three species Taenia solium (pork tapeworm), T. saginata (beef tapeworm), and T. asiatica, harboring the adult tapeworm in the small intestine. In this study, a structured questionnaire was circulated to assess the knowledge, attitudes, and practices (KAPs) regarding taeniasis among the rural and urban communities of Rawalpindi and Islamabad, Pakistan. A total of 770 individuals participated in the study. Of the total respondents, 44.4% had little knowledge about the disease and its impact, while the majority (70%) of respondents showed a willingness to participate in elimination campaigns by providing fecal samples. Most respondents kept raw meat separated from clean utensils (81.6%) and checked the internal temperature of meat when cooking it (75.1%). Regression analysis showed a significant association between age and knowledge, especially in the 20-30 years (p < 0.05; OR 0.574) and 30 to 40 years (p < 0.05; OR 0.553) age groups, and being a resident in Rawalpindi (p < 0.05; OR 0.68) and other cities (p < 0.05; OR 2.43), except Islamabad. Income ranges of 31,000-50,000 PKR (p < 0.05; OR: 0.574), 51,000-70,000 PKR (p < 0.05; OR 0.531), and above 70,000 PKR (p < 0.05; OR 0.42) were significantly related to attitude, compared with individuals with incomes of 10,000-30,000 PKR. Income above 70,000 PKR (p < 0.05; OR 0.87) and living in an urban area (p < 0.05; OR 0.616) compared to a rural area were significant with practices. A positive attitude was observed regarding awareness and prevention of the disease. Awareness campaigns and providing health education could be key approaches to manage this disease in the general population of developing countries.
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Affiliation(s)
- Saba Bibi
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan
| | - Muhammad Kamran
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan
- Department of Medical Laboratory Technology, Islamabad Medical and Dental College, Islamabad 45400, Pakistan
| | - Haroon Ahmad
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan
| | - Kainat Bibi
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan
| | - Syed Kamran Ul Hassan Naqvi
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan
| | - Qingqiu Zuo
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, National Health Commission of the People's Republic of China, Shanghai 200025, China
- WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China
| | - Naseer Ali Shah
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan
| | - Jianping Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, National Health Commission of the People's Republic of China, Shanghai 200025, China
- WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China
- The School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Alemayehu B, Kelbore AG, Alemayehu M, Adugna C, Bibo T, Megaze A, Leirs H. Knowledge, attitude, and practice of the rural community about cutaneous leishmaniasis in Wolaita zone, southern Ethiopia. PLoS One 2023; 18:e0283582. [PMID: 36976758 PMCID: PMC10047512 DOI: 10.1371/journal.pone.0283582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Cutaneous leishmaniasis (CL) is a neglected tropical disease that is caused by a Leishmania parasite and transmitted by the bite of infected female sandflies. Community awareness is an essential component of disease control and prevention. Therefore, this study aimed to assess the community's knowledge, attitude, and practice toward CL in Wolaita zone, southern Ethiopia. METHODS A community-based cross-sectional study design was employed to include 422 study subjects selected using a systematic sampling technique from two districts, Kindo Didaye and Sodo Zuria. A pretested structured questionnaire was used to collect data from the household heads. Bivariate and multivariate logistic regression analyses were performed to determine the relationship between the participants' knowledge about CL and socio-demographic characteristics. RESULTS Out of the 422 study participants, only 19% had good knowledge of CL in general. Most (67.1%) of the respondents knew CL by its local name ("bolbo" or "moora") though this knowledge varied highly over the study districts. The majority (86.3%) of respondents did not know how CL is acquired, though they considered CL a health problem. Most (62.8%) respondents believed that CL was an untreatable disease. Most (77%) participants responded that CL patients preferred to go to traditional healers for treatment. Herbal treatment was the most (50.2%) used to treat CL. Knowledge about CL was significantly associated with sex, age, and study districts. CONCLUSION The overall knowledge, attitude, and practice about CL and its prevention in the study area were low. This emphasizes the need to implement health education and awareness campaign to reduce the risk of CL infection. Policymakers and stakeholders should also give due attention to the prevention and treatment of CL in the study area.
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Affiliation(s)
- Bereket Alemayehu
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
| | - Abraham Getachew Kelbore
- Department of Dermatology, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Mihiretu Alemayehu
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Chimdesa Adugna
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Tessema Bibo
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Aberham Megaze
- Department of Biology, College of Natural and Computational Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Herwig Leirs
- Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
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Mounia A, Mohamed E, Mohamed H, Samia B. A Community Based Survey of Knowledge, Attitudes, and Practices Concerning Leishmaniasis in Central Morocco. J Community Health 2022; 47:932-942. [PMID: 35921052 DOI: 10.1007/s10900-022-01126-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2022] [Indexed: 12/26/2022]
Abstract
Leishmaniasis is a major health problem caused by a protozoan of the genus Leishmania, most commonly transmitted by infected female sand flies. Intersectoral collaboration is essential for the implementation of integrated vector management control with community participation. The present study aims to evaluate the knowledge, attitude and practices of the population toward leishmaniasis in central Morocco. A quantitative cross-sectional study was conducted using an administered questionnaire assisted by health professionals, on 750 people in the Marrakech Safi, endemic region of cutaneous leishmaniasis (CL). Of those, 702 agreed to be recruited for our study, of which 63,5% were women, 48,1% were aged between 18 and 40 years, and more than half of the participants (60%) were from rural areas. Overall, the knowledge, attitude and practices (KAPs) for leishmaniasis are too poor for more than 85% of the population in the study area. Basic knowledge and perceptions of leishmaniasis were good for 14,6% of respondents. While, 4,5% of the members had good knowledge of CL, only 0,7% had good level of knowledge about vesciral leishmaniasis (VL). Furthermore 3,7% of those polled have favorable attitudes and preventive practices. No association was found between knowledge and age, province or occupation. However, rural residents were four times more likely than urbain residents to have good basic knowledge (ORA = 4,74; CI95%: 1,04 -22,05). In addition, the female gender also has the chance to possess good basic knowledge and perceptions 3 times more than the men (ORA = 3,18; CI95%: 1,16 -8,69). The low level of KAPs regarding leishmaniasis proves the lack of community participation in the fight against leishmaniasis in central Morocco.
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Affiliation(s)
- Amane Mounia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.
| | - Echchakery Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Hafidi Mohamed
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco
| | - Boussaa Samia
- Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Research Unit Labelled CNRST N°4, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakech, Morocco.,Ministry of Health and Social Protection, ISPITS-Higher Institute of Nursing and Technical Health Occupations, Rabat, Morocco
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Dewasurendra R, Silva H, Samaranayake N, Manamperi N, de Silva N, Karunanayake P, Senarath U, Senanayake S, Zhou G, Karunaweera N. Assessment of knowledge and perceptions on leishmaniasis: An island-wide study in Sri Lanka. PLoS Negl Trop Dis 2022; 16:e0010821. [PMID: 36228029 PMCID: PMC9560589 DOI: 10.1371/journal.pntd.0010821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022] Open
Abstract
Cutaneous leishmaniasis (CL) is a notifiable disease in Sri Lanka with increasing case numbers reported from every part of the country. In addition to disease treatment and vector control measures, knowledge and perceptions in a community are key contributors to a successful intervention program. An island-wide survey was carried out to assess the knowledge and perceptions regarding CL across the island, with 252 confirmed CL cases and 2,608 controls. Data was collected by trained personnel, using a pre-tested Case Reporting Form (CRF). Although the percentage who referred to CL by its correct name was low (1.4%), majority stated that it is a fly induced skin disease (79.1%). Knowledge on the symptoms, curability and the name of the vector was high in these communities, but specific knowledge on vector breeding places, biting times and preventive methods were poor. The patients were more knowledgeable when compared to the controls. Differences in the level of knowledge could be identified according to the level of education of the participants as well as across the different areas of the country. The main source of information was through the healthcare system, but the involvement of media in educating the communities on the disease was minimal. While this study population was unaccustomed to the use of repellants or sprays, the use of bed nets was high (77.7% of the participants) in this study population. Although misconceptions and incorrect practices are rare in Sri Lankan communities, promoting health education programs which may improve disease awareness and knowledge on vector and its control will further strengthen the control and prevention strategies.
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Affiliation(s)
- Rajika Dewasurendra
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Hermali Silva
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nilakshi Samaranayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Nuwani Manamperi
- Department of Parasitology, Faculty of Medicine University of Kelaniya, Ragama, Sri Lanka
| | - Nissanka de Silva
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayawardenapura, Gangodawila, Nugegoda, Sri Lanka
| | - Panduka Karunanayake
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Upul Senarath
- Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sanath Senanayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Guofa Zhou
- University of California, Irvin, California, United States of America
| | - Nadira Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Knowledge, attitude, and practices towards cutaneous leishmaniasis in referral cases with cutaneous lesions: A cross-sectional survey in remote districts of southern Khyber Pakhtunkhwa, Pakistan. PLoS One 2022; 17:e0268801. [PMID: 35617283 PMCID: PMC9135282 DOI: 10.1371/journal.pone.0268801] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022] Open
Abstract
Background Cutaneous leishmaniasis is a neglected tropical disease caused by Leishmania spp. and transmitted by female sandflies. Terrorism and counter-insurgency military operations in Federally Administered Tribal Areas (FATA) lead to a large-scale migration of internally displaced persons (IDPs) in Khyber Pakhtunkhwa and thus, new outbreaks of several infectious diseases such as cutaneous leishmaniasis occurred. This study intended to find the prevalence of cutaneous leishmaniasis in people with cutaneous lesions suspected of having cutaneous leishmaniasis in four remote districts of Khyber Pakhtunkhwa and to assess the participant’s knowledge, attitude, and practices about the infection and its control. Methods A cross-sectional study was carried out in four remote districts of Khyber Pakhtunkhwa including Karak, Lakki Marwat, Tank, and Dera Ismail Khan (D. I. Khan) and a total of 1,674 participants were recruited using a convenience sampling technique. Results The prevalence of cutaneous leishmaniasis among the participants with cutaneous lesions was 50.4% and the infection was comparatively more prevalent in district Karak. Among participants, 56.8% were male and mostly, 53.8% were under the age of 16 years with 52.8% living in kutcha houses and were from rural areas. Multiple skin lesions were more common, and the face was frequently affected body part. The ratio of participants with lesions older than a month was higher and the majority confronted infections with blood protozoan parasites for the first time. Most participants were unaware of the signs/symptoms of the disease, basic knowledge of the vectors, anthroponotic spread, preventive measures, secondary infections, and reservoir hosts. The use of wood/animal dung as fuel, closeness with reservoir animals, and no use of insect repellents were some of the notable risk factors. Conclusion Cutaneous leishmaniasis is highly prevalent in the study area and a very low level of awareness was reported among the participants. This study necessitates the planning and execution of regulations and preventive programs, public health education, awareness campaigns, and disease management practices to overcome future incidence of cutaneous leishmaniasis.
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Numan M, Naz S, Gilani R, Minhas A, Ahmed H, Cao J. Evaluation of Household Preparedness and Risk Factors for Cutaneous Leishmaniasis (CL) Using the Community Assessment for Public Health Emergency Response (CASPER) Method in Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095068. [PMID: 35564462 PMCID: PMC9104477 DOI: 10.3390/ijerph19095068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022]
Abstract
(1) Background: In endemic areas of Pakistan, local community knowledge and attitudes towards cutaneous leishmaniasis (CL) are critical elements in the effective control and management of the disease. A cross-sectional epidemiologic design was used to assess the disease concern, preparedness, practices, and preventive behavior of the households and to assist the personnel and health care professionals in strengthening their planning efforts and awareness of CL. (2) Methods: A two-stage cluster sampling process, i.e., Community Assessment for Public Health Emergency Response (CASPER) was conducted from September 2020 to March 2021 on present household-level information about community needs and health status regarding CL in a cost-effective, timely, and representative manner. (3) Results: In the current study, 67% of the respondents were aware of CL and its causative agent and showed a low level of pandemic preparedness. The majority (74%) of the respondents mentioned that they did not avoid sandfly exposure areas. The majority (84%) of respondents had unsatisfactory behavior towards using bed nets, sprays, or repellents. (4) Conclusion: In endemic areas of Pakistan, the inadequate concern and low preparedness of the local community toward CL are critical aspects in efficient control and management of the disease.
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Affiliation(s)
- Muhammad Numan
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan;
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi 46000, Pakistan; (S.N.); (R.G.)
| | - Rehama Gilani
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi 46000, Pakistan; (S.N.); (R.G.)
| | - Azhar Minhas
- Department of Dermatology, Combined Military Hospital (CMH), Quetta 87300, Pakistan;
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad 45550, Pakistan;
- Correspondence: (H.A.); (J.C.)
| | - Jianping Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, National Health Commission of the People’s Republic of China, Shanghai 200025, China
- World Health Organization Collaborating Center for Tropical Diseases, Shanghai 200025, China
- The School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (H.A.); (J.C.)
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Dires A, Kumar P, Gedamu S, Yimam W, Ademe S. Knowledge, attitude and prevention measures of students towards cutaneous leishmaniasis in Delanta district, Northeast Ethiopia. Parasite Epidemiol Control 2022; 17:e00241. [PMID: 35146141 PMCID: PMC8818578 DOI: 10.1016/j.parepi.2022.e00241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 12/01/2021] [Accepted: 01/18/2022] [Indexed: 11/19/2022] Open
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Alidosti M, Heidari Z, Shahnazi H, Zamani-Alavijeh F. Behaviors and Perceptions Related to Cutaneous Leishmaniasis in Endemic Areas of the World: A Review. Acta Trop 2021; 223:106090. [PMID: 34389332 DOI: 10.1016/j.actatropica.2021.106090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/18/2021] [Accepted: 08/01/2021] [Indexed: 12/13/2022]
Abstract
The investigation of perceptions and behaviors associated with cutaneous leishmaniasis (CL) in different societies has indicated that mere attention to biological and medical aspects is not enough to prevent and control diseases and it is necessary to know the disease-associated behaviors and beliefs. The present study aimed to answer a question: what are the behaviors and perceptions associated with cutaneous leishmaniasis in endemic regions of the world?. This study is a review of the articles published on CL from January 2010 to January 2021, on the International databases Science Direct, Scopus and PubMed. We utilized the terms cutaneous leishmaniasis, in combination with some keywords, including belief, perceptions, knowledge, attitude, practices, prevention, and behavior. Non-original studies, including editorials, reviews, prefaces, brief communications, and letters to the editor, CL epidemiological articles, pre-published articles that has not been peer reviewed, and articles that not provide complete findings on CL-related perceptions and behaviors were excluded from the present paper. After screening, 25 articles from 17 regions of the world were included in the study. The results depicted a novel classification of behaviors and perceptions related to CL prevention and control. Two positive and negative categories of perceptions and behaviors were discovered. Positive perceptions and behaviors were classified into five categories, including: 1- good awareness, 2- perceived susceptibility, 3- perceived severity, 4- perceived response efficiency, and 5- appropriate behaviors. Furthermore, negative perceptions and behaviors were classified into four categories: 1- poor awareness 2- misconceptions (A. About the disease vector B.about the cause of the disease, C. about the consequences of the disease and the treatment process), 3- perceived barriers (A. in prevention, B. in medical treatment), and 4- misbehaviors (A. negligence, B. local and traditional behavioral patterns). In most endemic parts of the world, misconceptions are probably the leading cause of several misbehaviors in dealing with CL. It seems that providing educational programs to strengthen positive beliefs and correct negative beliefs are rooted in the studies in different countries and could be useful for improving the relevant behaviors and ultimately, taking a step towards the prevention and control of CL.
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Affiliation(s)
- Masoumeh Alidosti
- Student Research Committee, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Shahnazi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Tesfay K, Mardu F, Berhe B, Negash H, Legese H, Adhanom G, Belay G, Gebrewahid A, Tesfay S, Gufue ZH. Household knowledge, practice and treatment seeking behaviors towards cutaneous leishmaniasis in the endemic rural communities of Ganta- afeshum district, Tigrai, northern Ethiopia, 2019: a cross-sectional study. Trop Dis Travel Med Vaccines 2021; 7:19. [PMID: 34130733 PMCID: PMC8204582 DOI: 10.1186/s40794-021-00144-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 06/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cutaneous leishmaniasis is endemic to Ethiopia. However, the prevention and control efforts of leishmaniasis remain unfocused with clear knowledge and practice gaps within the country. Thus, a house to house survey has been carried out to assess the knowledge, practice and treatment-seeking behavior of households towards cutaneous leishmaniasis in the rural communities of Tigrai region, northern Ethiopia. METHODS A community-based cross-sectional house-to-house survey was conducted in two selected rural villages of Ganta-afeshum district, Tigrai, northern Ethiopia in 2019. A simple random sampling technique was employed to select the participants. Household heads were interviewed using a pre-tested semi-structured questionnaire. Epi info version 7.0 was used for data entry and the data were imported to SPSS version 23 for analysis. Chi-square test (χ2) was used to test the association between the independent variables and the knowledge and practice status of the study participants. P-value < 0.05 was used to declare a statistically significant association among the variables. RESULTS In our study, most of the participants (78%) stated that cutaneous leishmaniasis is a health problem in the area. Three hundred eighty (99.5%) participants responded that the most common clinical presentation of cutaneous leishmaniasis is a lesion on the face. All of the study participants did not know the mode of cutaneous leishmaniasis transmission, and had never heard of the sand fly. A majority of the participants were unaware of the main prevention methods for cutaneous leishmaniasis. Lastly, traditional medicine was used in 90% of the study households with a previous history for cutaneous leishmaniasis. CONCLUSION There is a lack of awareness regarding the transmission of cutaneous leishmaniasis in Ganta-afeshum, Ethiopia, where the majority of individuals are unfamiliar with the sand fly vector. Prevention methods for cutaneous leishmaniasis were unavailable among the community. Therefore, health education programs concerning cutaneous leishmaniasis transmission, prevention, and treatment in the area should be rigorously implemented.
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Affiliation(s)
- Kebede Tesfay
- Unit of Medical Parasitology and Entomology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia.
| | - Fitsum Mardu
- Unit of Medical Parasitology and Entomology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Brhane Berhe
- Unit of Medical Parasitology and Entomology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Hadush Negash
- Unit of Microbiology and Immunology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Haftom Legese
- Unit of Microbiology and Immunology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Gebre Adhanom
- Unit of Microbiology and Immunology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Getachew Belay
- Unit of Clinical Chemistry, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | - Aderajew Gebrewahid
- Unit of Microbiology and Immunology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | | | - Zenawi Hagos Gufue
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
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Karunaweera ND, Ginige S, Senanayake S, Silva H, Manamperi N, Samaranayake N, Siriwardana Y, Gamage D, Senerath U, Zhou G. Spatial Epidemiologic Trends and Hotspots of Leishmaniasis, Sri Lanka, 2001-2018. Emerg Infect Dis 2021; 26:1-10. [PMID: 31855147 PMCID: PMC6924882 DOI: 10.3201/eid2601.190971] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Leishmaniasis, a neglected tropical disease, is on the decline in South Asia. However, cases of cutaneous leishmaniasis have risen in Sri Lanka since 2001, and the lack of in-depth research on its epidemiologic characteristics hampers control efforts. We analyzed data collected from patients with cutaneous leishmaniasis in Sri Lanka during 2001-2018 to study temporal and geographic trends and identify and monitor disease hotspots. We noted a progression in case rates, including a sharp rise in 2018, showing temporal expansion of disease-prevalent areas and 2 persistent hotspots. The northern hotspot shifted and shrank over time, but the southern hotspot progressively expanded and remained spatially static. In addition, we noted regional incidence differences for age and sex. We provide evidence of temporally progressive and spatially expanding incidence of leishmaniasis in Sri Lanka with distinct geographic patterns and disease hotspots, signaling an urgent need for effective disease control interventions.
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Irum S, Aftab M, Khan A, Naz S, Simsek S, Habib A, Afzal MS, Nadeem MA, Qasim M, Ahmed H. Cutaneous Leishmaniasis (CL): A Cross-Sectional Community Based Survey on Knowledge, Attitude and Practices in a Highly Endemic Area of Waziristan (KPK Province), Pakistan. Acta Trop 2021; 213:105746. [PMID: 33160955 DOI: 10.1016/j.actatropica.2020.105746] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 09/09/2020] [Accepted: 10/01/2020] [Indexed: 11/27/2022]
Abstract
Recent outbreaks of Cutaneous Leishmaniasis (CL) in Waziristan make the disease a public health concern in Khyber Pakhtunkhwa (KPK) province, Pakistan. The awareness and behavior of local community towards the disease is an important factor towards effective control and management of CL in endemic areas of Pakistan. A cross-sectional community based survey was piloted in new emerging district of North Waziristan Agency (KPK province), Pakistan from August 2019- February 2020. The study aimed to examine the Knowledge, Attitude and Practices (KAP) of the local community members regarding CL. The results revealed that majority of the participants were male. Only 48.2% participants have knowledge about CL and the respondents had a moderate knowledge of CL vector and the disease. Few of the respondents were aware that CL is caused by sand flies, their breeding place, biting time, transmission of CL and control measures. Skin infection and sand-flies were the main disease symptoms and disease vector were known to some of the respondents. Most of the respondents showed positive attitude towards disease seriousness and believed that the disease could be cured and can be treated through modern medicines. Admission to hospitals, cleanliness and use of bed nets were the treatment measures for the disease in suspected patients, whereas some believed that the use of bed nets could be helpful in preventing the leishmaniasis. Moderate knowledge of the CL and its transmission in the study area emphasize the need to initiate health education and awareness campaigns to reduce the disease risk and burden in this highly endemic area in near future.
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Affiliation(s)
- Shamaila Irum
- Department of Zoology, University of Gujrat, Gujrat, Pakistan
| | - Malik Aftab
- Department of Zoology, University of Gujrat, Gujrat, Pakistan
| | - Aisha Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Shumaila Naz
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Ayesha Habib
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad, Pakistan
| | - Muhammad Sohail Afzal
- Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore, Pakistan
| | - Muhammad Arif Nadeem
- Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore, Pakistan
| | - Muhammad Qasim
- Department of Economics, Finance and Statistics, Jönköping International Business School, Jönköping University, Sweden
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Park Road, Chak Shahzad, Islamabad, Pakistan.
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Hewawasam C, Weerakoon HS, Thilakan V, Lelwala T, Prasanka K, Rathnayaka AS, Gamage S, Agampodi S. Is leishmaniasis adequately notified in Sri Lanka? A survey among doctors from an endemic district, Sri Lanka. BMC Public Health 2020; 20:913. [PMID: 32532244 PMCID: PMC7290071 DOI: 10.1186/s12889-020-09066-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/05/2020] [Indexed: 01/23/2023] Open
Abstract
Background Leishmaniasis is a notifiable disease in Sri Lanka since 2008. Previous studies show a gap in the notification of leishmaniasis. The purpose of the present study was to determine the Knowledge, attitudes and practice of medical officers regarding leishmaniasis. Methods A cross-sectional study was conducted in the Anuradhapura district which reported the highest case load of leishmaniasis. Medical officers from public and private health care institutes in the area filled a self-administered questionnaire in the presence of the investigators. Results One hundred and eighty-eight (188) medical officers completed the questionnaire. Of them, 95.7% were aware of leishmaniasis as a parasitic infection and 84.7% correctly identified Leishmania donovani as the causative organism in Sri Lanka. From the respondents, 181 (96.8%) knew that the vector of leishmaniasis is sand fly. Cutaneous leishmaniasis was reported as the most prevalent form of leishmaniasis in the country by 176 (94.1%). Nearly half of the respondents (98, 54.1%) were aware of the fact that the Anuradhapura district has the highest disease burden. Many of them had the idea that leishmaniasis is an emerging disease (155, 84.3%,) and early diagnosis is important in controlling the disease (163, 89.1%). Although about three fourth (123, 73.7%,) of the participants mentioned that leishmaniasis should be notified at first clinical suspicion, only 74 (42.5%) were aware that it is a legal requirement. Some medical officers (39, 22%) believed that the current notification system in the country is not effective. Unavailability of notification forms (60, 36.8%) heavy workload (85, 50.3%) and inadequate supportive staff (55, 35.1%) were reported as barriers for timely notification. Even though 105 (58.0%) of medical officers had suspected leishmaniasis during the last 8 years period only 35 (19.4%) had notified. Conclusions Even though more than 90% of the participants had good theoretical knowledge about leishmaniasis; notification of leishmaniasis is considerably inadequate. This study emphasizes the need for greater efforts to improve the notification of leishmaniasis in Sri Lanka.
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Affiliation(s)
- Chandana Hewawasam
- Department of Physiology, Faculty of Medicine and Allied Health Sciences, Rajarata University, Saliyapura, Sri Lanka.
| | - Hema S Weerakoon
- Medical Officer/Public Health, Office of the Provincial Director of Health Services, Anuradhapura, Sri Lanka
| | - Vyshnavi Thilakan
- Department of Community Medicine, Faculty of Medicine and Allied Health Sciences, Rajarata University, Saliyapura, Sri Lanka
| | - Tishni Lelwala
- Department of Community Medicine, Faculty of Medicine and Allied Health Sciences, Rajarata University, Saliyapura, Sri Lanka
| | - Kalana Prasanka
- Department of Community Medicine, Faculty of Medicine and Allied Health Sciences, Rajarata University, Saliyapura, Sri Lanka
| | - A S Rathnayaka
- Office of the Regional Director of Health Services, Anuradhapura, Sri Lanka
| | - Shanika Gamage
- Department of Community Medicine, Faculty of Medicine and Allied Health Sciences, Rajarata University, Saliyapura, Sri Lanka
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Health Sciences, Rajarata University, Saliyapura, Sri Lanka
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Tamiru HF, Mashalla YJ, Mohammed R, Tshweneagae GT. Cutaneous leishmaniasis a neglected tropical disease: community knowledge, attitude and practices in an endemic area, Northwest Ethiopia. BMC Infect Dis 2019; 19:855. [PMID: 31619180 PMCID: PMC6796443 DOI: 10.1186/s12879-019-4506-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/24/2019] [Indexed: 01/16/2023] Open
Abstract
Background Cutaneous leishmaniasis is one of the neglected tropical diseases in the Ethiopian highlands and studies on assessment of knowledge, attitude and practice of the community in endemic areas are scanty. The study aimed to assess the knowledge, attitude towards cutaneous leishmaniasis and treatment seeking practices in people living in the endemic highlands areas in the Northwest, Ethiopia and to provide evidence-based information to guide development of appropriate interventions to reduce the impact of cutaneous leishmaniasis on communities. Methods Quantitative cross-sectional study was conducted in cutaneous leishmaniasis endemic districts (woredas) using a semi structured questionnaire. Households were randomly selected according to probability proportional to size of households in each enumeration area. Systematic random sampling of eligible households was based on the number of households recorded during listing of households. Descriptive statistics was used to describe numerical data, organise and summarise the data in a manner that gave meaning to the numerical form. Frequency tables were used to show descriptive analysis and regression analysis was used to determine correlation between variables. Results Majority of respondents 321(78.7%) lived in rural areas, age ranged between 18 and 85 years and most were farmers. Illiteracy was high (47.6%) among respondents and majority 358(87.8%) had seen patients with CL. Less than quarter (21.6%) had heard about sand flies and knowledge on the peak transmission period was low (46.3%). About 192 (47.1%) of the respondents indicated disfiguring lesions were the major clinical presentations, less than half 55(27.5%) of urban residents believed CL was treatable compared to 145(72.5%) of rural residents (P < 0.001). Traditional medicines were indicated as best treatment option by 209(51.2%) compared to 114(27.9%) for modern treatment. Major factors influencing treatment options included accessibility to treatment facilities, distance and short duration of treatment. Participants expressed negative experiential attitude and perceived control towards modern treatment because of inaccessibility and distance from where modern treatment is provided. Conclusion Priority should be given to primary prevention and appropriate awareness campaigns on lesion recognition. Information on modern treatment should be intensified.
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Affiliation(s)
- Helina Fikre Tamiru
- Department of Health Studies, University of South Africa, Pretoria, South Africa.,Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
| | - Yohana James Mashalla
- Department of Health Studies, University of South Africa, Pretoria, South Africa. .,Faculty of Medicine, University of Botswana, Gaborone, Botswana.
| | - Rezika Mohammed
- Leishmaniasis Research and Treatment Centre, University of Gondar, Gondar, Ethiopia
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Jeihooni AK, Harsini PA, Kashfi SM, Rakhshani T. Effect of educational intervention based on the PRECEDE-PROCEED model on preventive behaviors of cutaneous leishmaniasis among housewives. CAD SAUDE PUBLICA 2019; 35:e00158818. [PMID: 31365701 DOI: 10.1590/0102-311x00158818] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/06/2019] [Indexed: 11/22/2022] Open
Abstract
Leishmaniasis is an endemic disease in Iran. Since education to prevent the disease is important, this study aimed to determine the effect of educational intervention based on the PRECEDE-PROCEED model on preventive behaviors of cutaneous leishmaniosis among housewives. In this quasi-experimental study, 240 housewives under the coverage of health centers, who lived in the endemic area of Mianshahr, Fasa city, Fars Province, Iran in 2016, were selected (120 people for the experimental group and 120 for the control group). The educational intervention for the experimental group was based on the PRECEDE model, which consists of seven 50-60-minute sessions of lectures, group discussions, role playing, practical displays, and video and PowerPoint displays. These sessions addressed the familiarity with cutaneous leishmaniasis and its different types and carriers, methods of preventing and fighting against it, personal protection, sanitation of the environment and drinking water, spraying of sites, use of mosquito nets, etc. Data were collected before educational intervention and three months after educational intervention. The mean age of the experimental group was 39.24±9.12 years and that of the control group was 38.84±9.28 years. Three months after the intervention, the experimental group showed a significant increase in knowledge, attitudes, reinforcing factors, enabling factors, and performance compared to the control group. The education based on enabling factors, reinforcing factors, and predisposing factors had a significant effect on the preventive behaviors of cutaneous leishmaniasis among housewives.
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Bailey F, Mondragon-Shem K, Haines LR, Olabi A, Alorfi A, Ruiz-Postigo JA, Alvar J, Hotez P, Adams ER, Vélez ID, Al-Salem W, Eaton J, Acosta-Serrano Á, Molyneux DH. Cutaneous leishmaniasis and co-morbid major depressive disorder: A systematic review with burden estimates. PLoS Negl Trop Dis 2019; 13:e0007092. [PMID: 30802261 PMCID: PMC6405174 DOI: 10.1371/journal.pntd.0007092] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/07/2019] [Accepted: 12/18/2018] [Indexed: 11/18/2022] Open
Abstract
Background Major depressive disorder (MDD) associated with chronic neglected tropical diseases (NTDs) has been identified as a significant and overlooked contributor to overall disease burden. Cutaneous leishmaniasis (CL) is one of the most prevalent and stigmatising NTDs, with an incidence of around 1 million new cases of active CL infection annually. However, the characteristic residual scarring (inactive CL) following almost all cases of active CL has only recently been recognised as part of the CL disease spectrum due to its lasting psychosocial impact. Methods and findings We performed a multi-language systematic review of the psychosocial impact of active and inactive CL. We estimated inactive CL (iCL) prevalence for the first time using reported WHO active CL (aCL) incidence data that were adjusted for life expectancy and underreporting. We then quantified the disability (YLD) burden of co-morbid MDD in CL using MDD disability weights at three severity levels. Overall, we identified 29 studies of CL psychological impact from 5 WHO regions, representing 11 of the 50 highest burden countries for CL. We conservatively calculated the disability burden of co-morbid MDD in CL to be 1.9 million YLDs, which equalled the overall (DALY) disease burden (assuming no excess mortality in depressed CL patients). Thus, upon inclusion of co-morbid MDD alone in both active and inactive CL, the DALY burden was seven times higher than the latest 2016 Global Burden of Disease study estimates, which notably omitted both psychological impact and inactive CL. Conclusions Failure to include co-morbid MDD and the lasting sequelae of chronic NTDs, as exemplified by CL, leads to large underestimates of overall disease burden. Cutaneous leishmaniasis is a highly prevalent vector-borne disease affecting large parts of Latin America and the Middle East, as well as parts of Northern Africa. There are several types of Cutaneous leishmaniasis, almost all of which have an active phase characterized by a disfiguring lesion (typically on exposed parts of the body), which then becomes a permanent scar (the inactive phase). We recently published an article highlighting the impact of the inactive scarring phase of CL on affected individuals, which is associated with high levels of stigma. Nevertheless, this aspect of the disease is not considered in its own right when calculating the overall disease burden by the Global Burden of Disease (GBD) Studies. In this article we estimate the prevalence of depression (major depressive disorder) in cutaneous leishmaniasis, in both the active and inactive forms. We then show the contribution of inactive CL to the overall disease burden estimates when included, which is due to the large psychological impact it has on those affected by it. We also highlight the importance of further similar efforts for other NTDs which have a chronic course, and which are also not sufficiently included in disease burden calculations at present.
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Affiliation(s)
- Freddie Bailey
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Milton Keynes University Hospital, Eaglestone, Milton Keynes, United Kingdom
- * E-mail: (FB); (DHM)
| | - Karina Mondragon-Shem
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Lee Rafuse Haines
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Amina Olabi
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Ahmed Alorfi
- National Centre for Tropical Diseases, National Health Laboratory, Ministry of Health—Kingdom of Saudi Arabia, Riyadh, Kingdom of Saudi Arabia
| | | | - Jorge Alvar
- Drugs for Neglected Disease Initiative, Geneva, Switzerland
| | - Peter Hotez
- National School of Tropical Medicine, Baylor College of Medicine, Texas, United States of America
| | - Emily R. Adams
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - Iván D. Vélez
- Programa de Estudio y Control de Enfermedades Tropicales PECET, Universidad de Antioquia, Medellín, Colombia
| | - Waleed Al-Salem
- National Centre for Tropical Diseases, National Health Laboratory, Ministry of Health—Kingdom of Saudi Arabia, Riyadh, Kingdom of Saudi Arabia
| | - Julian Eaton
- CBM International, Dry Drayton Road, Oakington, Cambridge, United Kingdom
- London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom
| | - Álvaro Acosta-Serrano
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
| | - David H. Molyneux
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, United Kingdom
- * E-mail: (FB); (DHM)
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Thakur L, Singh KK, Shanker V, Negi A, Jain A, Matlashewski G, Jain M. Atypical leishmaniasis: A global perspective with emphasis on the Indian subcontinent. PLoS Negl Trop Dis 2018; 12:e0006659. [PMID: 30260957 PMCID: PMC6159859 DOI: 10.1371/journal.pntd.0006659] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Among the neglected tropical diseases, leishmaniasis continues to be prevalent in many tropical and subtropical countries despite international, national, and local efforts towards its control and elimination over the last decade. This warrants a critical evaluation of such factors as under-reporting, asymptomatic infections, post kala azar dermal leishmaniasis (PKDL) cases, and drug resistance. In this review, we highlight lesser-understood atypical presentations of the disease involving atypical parasite strains against a background of classical leishmaniasis with a focus on the Indian subcontinent. METHODS AND FINDINGS A literature review based on endemic areas, the nature of disease manifestation, and underlying causative parasite was performed with data collected from WHO reports for each country. Searches on PubMed included the term ''leishmaniasis" and "leishmaniasis epidemiology" alone and in combination with each of the endemic countries, Leishmania species, cutaneous, visceral, endemic, non-endemic, typical, classical, atypical, and unusual with no date limit and published in English up to September 2017. Our findings portray a scenario with a wider distribution of the disease in new endemic foci, with new discoveries of parasite-driven atypical disease manifestations in different regions of the world. Unlike the classical picture, some Leishmania species are associated with more than one disease presentation, e.g., the L. donovani complex, generally associated with the visceral form, is now also associated with a cutaneous disease presentation, while L. tropica species complex, known to cause cutaneous disease, can cause viscerotropic disease. This phenomenon points towards the discovery of novel parasite variants as etiologic agents of atypical disease manifestations and represents an excellent opportunity to identify and study genes that control disease virulence and tropism. CONCLUSIONS The increased recognition of atypical leishmaniasis as an outcome of parasite variants has major implications for leishmaniasis control and elimination. Identifying molecular correlates of parasite isolates from distinct regions associated with different disease phenotypes is required to understand the current epidemiology of leishmaniasis in regions with atypical disease.
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Affiliation(s)
- Lovlesh Thakur
- Department of Animal Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Kiran K. Singh
- Department of Geography and Geology, Central University of Punjab, Bathinda, Punjab, India
| | - Vinay Shanker
- Department of Dermatology and Venereology, Maharishi Markandeshwar Medical College and Hospital, Sultanpur, Kumarhatti, Solan, Himachal Pradesh, India
| | - Ajeet Negi
- Department of Dermatology, Indira Gandhi Medical Centre, Shimla, Himachal Pradesh, India
| | - Aklank Jain
- Department of Animal Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada
| | - Manju Jain
- Department of Biochemistry and Microbial Sciences, Central University of Punjab, Bathinda, Punjab, India
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"The mosquitoes that destroy your face". Social impact of Cutaneous Leishmaniasis in South-eastern Morocco, A qualitative study. PLoS One 2017; 12:e0189906. [PMID: 29261762 PMCID: PMC5738074 DOI: 10.1371/journal.pone.0189906] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 12/04/2017] [Indexed: 11/19/2022] Open
Abstract
Objective To document the psychosocial burden of Cutaneous Leishmaniasis (CL) in rural communities in Southeastern Morocco. Method Between 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. Results This 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. Conclusions The 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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Kebede N, Worku A, Ali A, Animut A, Negash Y, Gebreyes WA, Satoskar A. Community knowledge, attitude and practice towards cutaneous leishmaniasis endemic area Ochello, Gamo Gofa Zone, South Ethiopia. Asian Pac J Trop Biomed 2016. [DOI: 10.1016/j.apjtb.2016.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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