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Alderton DL, Ackley C, Trueba ML. The psychosocial impacts of skin-neglected tropical diseases (SNTDs) as perceived by the affected persons: A systematic review. PLoS Negl Trop Dis 2024; 18:e0012391. [PMID: 39093848 PMCID: PMC11324132 DOI: 10.1371/journal.pntd.0012391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/14/2024] [Accepted: 07/21/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Neglected Tropical Diseases (NTDs) disproportionately affect marginalised groups within impoverished communities, conferring devastating physical, financial and psychosocial effects. Skin-NTDs (SNTDs) are uniquely stigmatising due to their visible nature, rendering affected individuals vulnerable to psychosocial risk and the associated decline in social participation, quality of life and mental health. In response to knowledge gaps identified by current global efforts for integrated control of SNTDs this review gathers existing evidence on the psychosocial effects of SNTDs, with consideration given to the influence of gender. METHODS The study protocol is registered with PROSPERO (CRD42022336676). Data was collected from Embase, Global Health, Medline and Web of Science, with additional articles identified through Google Scholar and bibliography tracking. Qualitative studies published in English between 2005 and 2024 reporting men's and women's experiences with SNTDs were searched. Appropriate data from each included study were inputted into NVivo software to facilitate thematic synthesis. Descriptive and analytic themes were generated through line-by-line coding using an inductive approach. RESULTS 27 articles of high and moderate quality were included. They pertained to buruli ulcer, cutaneous leishmaniasis, leprosy, lymphatic filariasis, tungiasis, onchocerciasis, schistosomiasis and podoconiosis. Men and women across SNTDs and contexts reported debilitating physical symptoms which impaired their ability to work, socialise and carry out usual daily activities. Some felt (at least initially) well supported by partners and relatives, whereas most experienced avoidance, abandonment and even violence, with women incurring worse SNTD-related social consequences. Many men and most women experienced stigma, with discriminatory behaviours largely attributed to fear of infection, decreased ability to perform gender-specific daily activities, and the perceived association between SNTDs and sinfulness. Self-reported impacts of SNTDs on men's and women's mental wellbeing included low mood, anxiety, low self-esteem, and suicidal ideation. Disease-specific knowledge, early treatment, social support, and disease acceptance were mentioned as protective factors. CONCLUSION SNTDs cause significant psychosocial harms, particularly for women. Implementing myth-busting and contact-based educational campaigns and improving access to treatment and to livelihood opportunities and social protection schemes for men and women with a SNTD will help prevent and mitigate these.
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Affiliation(s)
- Dasha L. Alderton
- Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, United Kingdom
| | - Caroline Ackley
- Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, United Kingdom
| | - Mei L. Trueba
- Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, United Kingdom
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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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Elfaki NK, Alzahrani MJ, Abdalla YHA, Adeh AI, Osman Abdalla AMA, Alkhadher MA, Elrefaey SR, Abdelmagid WHH, Alshameri F, Jarelnape AA, Hakami MSA, Alghamdi FAA, Elhaj YHA, Dinar NMAA, Mohamed AAA, Abdulrahman EEH, Mohamed DHM, Sagiron EI, Ali MHM, Ahmed WAM. Perceived Social Stigma of Cutaneous Leishmaniasis in Hubuna, Saudi Arabia. J Multidiscip Healthc 2024; 17:867-876. [PMID: 38434481 PMCID: PMC10909324 DOI: 10.2147/jmdh.s454135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
Background Cutaneous Leishmaniasis (CL) is a vector-borne skin infection that remains prevalent in regions with poor socioeconomic conditions. Stigmatization occurs when individuals with physical or psychological disorders interact with societal stereotypes. The aim of this study was to explore the perceived social stigma surrounding CL among people residing in Hubuna, Saudi Arabia. Methods This cross-sectional community-based survey recruited 618 individuals aged 18 years and above using the snowball sampling technique to reach hidden cases within the target population. Data was collected using a self-administered questionnaire and the Explanatory Model Interview Catalogue for Perceived Social Stigma (EMIC-SS-12) was used to assess the level of perceived social stigma. It includes questions on demographic variables, behaviors, and experiences. The analysis was performed using SPSS. Results The study included 618 participants, the majority of whom were women and girls (54.2%), with a mean age of 28 ± 12.7 years. The median score for perceived social stigma was 26.0. Only 2.1% (n = 13) of participants had the highest EMIC-SS-12 score of 36, while 7.6% (n = 47) scored zero. The mean score for overall perceived social stigma was 1.89 ± 0.91, while the mean score for experienced stigma was 1.99 ± 1.02. Univariate analysis showed that sex, employment, location of lesions, and number of lesions were insignificantly associated with stigmatization (P-value < 0.05), because these associations were uncertain because the CI includes or very close to 1. Conclusion The study reveals insights into stigmatization associated with CL in the Habuna area of Saudi Arabia. It found that the median of perceived social stigma was 26. Factors such as sex, employment status, and location of the lesion are uncertainly associated with stigma. It is crucial to explore negative behaviors and perceptions and develop suitable health education programs.
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Affiliation(s)
- Nahid K Elfaki
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Yahya Hussein Ahmed Abdalla
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Abdullah I Adeh
- Internal Medicine Department, College of Medicine, Najran University, Najran, Saudi Arabia
| | | | - Mugahed A Alkhadher
- Medical- Surgical Nursing Department, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Samah R Elrefaey
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | | | - Faroq Alshameri
- Nursing Department, Faculty of Medical Sciences and Nursing, Alrayan Colleges, Almadina, Saudi Arabia
| | | | | | | | - Yagoub Hamadt Allah Elhaj
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Al-Baha University, Al-Baha, Saudi Arabia
| | | | | | | | | | - Elwaleed Idris Sagiron
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
| | - Maha Hamed Mohamed Ali
- Department of Community and Mental Health Nursing, College of Nursing, Najran University, Najran, Saudi Arabia
- Public Health Department, Faculty of Applied Medical Sciences, King Khalid University, Khamis Mushait Aseer, Saudi Arabia
| | - Waled A M Ahmed
- Faculty of Nursing, Al-Baha University, Al-Baha, Saudi Arabia
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Community-Based Interventions for the Prevention and Control of Cutaneous Leishmaniasis: A Systematic Review. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organization. We searched nine electronic databases for intervention-based studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD: 1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore, we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).
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