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University of Antwerp (2018)

Cutaneous leishmaniasis in Morocco : psychosocial burden and simplified diagnosis

Bennis Issam

Titre : Cutaneous leishmaniasis in Morocco : psychosocial burden and simplified diagnosis

Cutane leishmaniase in Marokko : psychosociale belasting en vereenvoudigde diagnose

Auteur : Bennis Issam

Université de soutenance : University of Antwerp

Grade : Doctor of Biomedical Sciences 2018

Résultats
Between 2004 and 2013, 7099 cases of CL were recorded in Errachidia Province. This outbreak due to L. major left many adolescents with permanent scar tissue on the face or other exposed body parts. Almost 20% of 448 high school students reported a CL lesion and 87% said it could lead to psychological consequences. The indelible CL scars lead to self-stigma and social stigma, and the emergence of adverse psychological effects. Adult participants in the focus groups considered the impact of CL lesions and scars as important. Young women with CL scars in the face are stigmatized and may 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. They expressed a real demand for better treatment. The scoping review confirmed that localized CL is a source of pronounced psychological suffering, stigmatization, and reduction of quality of life in several endemic countries. In the third part, the RDT showed a sensitivity of 68% [95% CI, 61-74]), a specificity of 94% [95% CI, 91-97]), a positive predictive value of 95% [95% CI, 92-98] and a negative predictive value of 64% [95% CI, 58-70]. Species typing on a subsample of 87 PCR positives using PCR-RFLP and PCRsequencing identified L. tropica (n=40), L. major (n=35) and L. infantum (n=12). Our findings suggest that this novel RDT for CL is a useful addition to clinical management in Morocco, especially in isolated localities far from provincial laboratories.

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Page publiée le 18 mars 2021