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Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia

Although non-fatal and mostly self-healing in the case of Leishmania (L.) major, cutaneous leishmaniasis (CL) is mainly treated to reduce lesion healing time. Less attention is paid to the improvement of scars, especially in aesthetically relevant areas of the body, which can dramatically affect pat...

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Autores principales: Boukthir, Aicha, Bettaieb, Jihene, Erber, Astrid C., Bouguerra, Hind, Mallekh, Rym, Naouar, Ikbel, Gharbi, Adel, Alghamdi, Manal, Plugge, Emma, Olliaro, Piero, Ben Salah, Afif
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707605/
https://www.ncbi.nlm.nih.gov/pubmed/33259489
http://dx.doi.org/10.1371/journal.pone.0242494
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author Boukthir, Aicha
Bettaieb, Jihene
Erber, Astrid C.
Bouguerra, Hind
Mallekh, Rym
Naouar, Ikbel
Gharbi, Adel
Alghamdi, Manal
Plugge, Emma
Olliaro, Piero
Ben Salah, Afif
author_facet Boukthir, Aicha
Bettaieb, Jihene
Erber, Astrid C.
Bouguerra, Hind
Mallekh, Rym
Naouar, Ikbel
Gharbi, Adel
Alghamdi, Manal
Plugge, Emma
Olliaro, Piero
Ben Salah, Afif
author_sort Boukthir, Aicha
collection PubMed
description Although non-fatal and mostly self-healing in the case of Leishmania (L.) major, cutaneous leishmaniasis (CL) is mainly treated to reduce lesion healing time. Less attention is paid to the improvement of scars, especially in aesthetically relevant areas of the body, which can dramatically affect patients’ wellbeing. We explored patients’ perspectives about treatment options and the social and psychological burden of disease (lesion and scar). Individual in-depth interviews were conducted with ten confirmed CL patients at two L. major endemic sites in Southern Tunisia (Sidi Bouzid and Gafsa). Participants were selected using a sampling approach along a spectrum covering e.g. age, sex, and clinical presentation. Patients’ experiences, opinions and preferences were explored, and their detailed accounts gave an insight on the impact of CL on their everyday lives. The impact of CL was found to be considerable. Most patients were not satisfied with treatment performance and case management. They expected a shorter healing time and better accessibility of the health system. Tolerance of the burden of disease was variable and ranged from acceptance of hidden scars to suicidal thoughts resulting from the fear to become handicapped, and the stress caused by close relatives. Some believed CL to be a form of skin cancer. Unexpectedly, this finding shows the big gap between the perspectives of patients and assumptions of health professionals regarding this disease. This study provided valuable information for better case management emphasizing the importance of improving communication with patients, and accessibility to treatment. It generated context-specific knowledge to policy makers in Tunisia to implement effective case management in a country where access to treatment remains a challenge due to socio-economic and geographic barriers despite a long tradition in CL control.
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spelling pubmed-77076052020-12-08 Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia Boukthir, Aicha Bettaieb, Jihene Erber, Astrid C. Bouguerra, Hind Mallekh, Rym Naouar, Ikbel Gharbi, Adel Alghamdi, Manal Plugge, Emma Olliaro, Piero Ben Salah, Afif PLoS One Research Article Although non-fatal and mostly self-healing in the case of Leishmania (L.) major, cutaneous leishmaniasis (CL) is mainly treated to reduce lesion healing time. Less attention is paid to the improvement of scars, especially in aesthetically relevant areas of the body, which can dramatically affect patients’ wellbeing. We explored patients’ perspectives about treatment options and the social and psychological burden of disease (lesion and scar). Individual in-depth interviews were conducted with ten confirmed CL patients at two L. major endemic sites in Southern Tunisia (Sidi Bouzid and Gafsa). Participants were selected using a sampling approach along a spectrum covering e.g. age, sex, and clinical presentation. Patients’ experiences, opinions and preferences were explored, and their detailed accounts gave an insight on the impact of CL on their everyday lives. The impact of CL was found to be considerable. Most patients were not satisfied with treatment performance and case management. They expected a shorter healing time and better accessibility of the health system. Tolerance of the burden of disease was variable and ranged from acceptance of hidden scars to suicidal thoughts resulting from the fear to become handicapped, and the stress caused by close relatives. Some believed CL to be a form of skin cancer. Unexpectedly, this finding shows the big gap between the perspectives of patients and assumptions of health professionals regarding this disease. This study provided valuable information for better case management emphasizing the importance of improving communication with patients, and accessibility to treatment. It generated context-specific knowledge to policy makers in Tunisia to implement effective case management in a country where access to treatment remains a challenge due to socio-economic and geographic barriers despite a long tradition in CL control. Public Library of Science 2020-12-01 /pmc/articles/PMC7707605/ /pubmed/33259489 http://dx.doi.org/10.1371/journal.pone.0242494 Text en © 2020 Boukthir et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Boukthir, Aicha
Bettaieb, Jihene
Erber, Astrid C.
Bouguerra, Hind
Mallekh, Rym
Naouar, Ikbel
Gharbi, Adel
Alghamdi, Manal
Plugge, Emma
Olliaro, Piero
Ben Salah, Afif
Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia
title Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia
title_full Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia
title_fullStr Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia
title_full_unstemmed Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia
title_short Psycho-social impacts, experiences and perspectives of patients with Cutaneous Leishmaniasis regarding treatment options and case management: An exploratory qualitative study in Tunisia
title_sort psycho-social impacts, experiences and perspectives of patients with cutaneous leishmaniasis regarding treatment options and case management: an exploratory qualitative study in tunisia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7707605/
https://www.ncbi.nlm.nih.gov/pubmed/33259489
http://dx.doi.org/10.1371/journal.pone.0242494
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