Stigmata in cutaneous leishmaniasis: Historical and
new evidence-based concepts
Title Stigmata in
cutaneous leishmaniasis: Historical and new evidence-based concepts.
Publication Type Journal
Article
Authors Dr. Mohamed Ahmed Al-Kamel د/ محمد أحمد نايف الكامل
Journal Our Dermatol
Online
Year of Publication 2017
Volume 8
Issue 1
Pagination 1-10
Publication Language eng
Keywords Cutaneous
Leishmaniasis (CL), Neglected tropical diseases (NTDs), Stigma, Stigma (health
related), Yemen
Abstract
This
report is a part of many articles and studies published by the Regional
Leishmaniasis Control Center (RLCC). Willing that this review might enrich
understanding of the global epidemiological profile of CL, the author relied on
research evidence, his experience and a social survey to highlight historical
and current concepts of cutaneous leishmaniasis (CL) as a globally most prevalent
and highly stigmatizing form of leishmaniasis disease, introduce new ideologies
upon CL-related stigmata, review the most common determinants and implications
of CL stigmata; and report a short survey illustrating stigmata experience
among some affected patients from Yemen. He also reviewed a successful
community-led action to reduce the burden of CL and its related stigmata in
Yemen.
Conclusion
Apart from its physical impact, it is evident that CL poses severe and spectral stigmata with considerable implications upon the physical, moral, social, economic and public health contexts that may kill stigmatized individuals, both socially and literally. The author has identified and classified CL related stigmata into three types: (1) CL Social Stigma (CLSS), which might be perceived, enacted or internalized; (2) CL Aesthetic Stigma (CLAS), which might be might be perceived or enacted; (3) CL Psychological Stigma (CLPS). Almost, every patient with CL may has at least one of the three CL-related stigmata. CLAS is the differential feature that cause stigmatization in CL to look more challengeable, spectral and different from that of all other comparable neglected tropical diseases, such as leprosy. Social and aesthetic stigmata are synonyms of CL in some countries, such as Yemen, and young women are the most affected sex group. Although, CL is stigmatizing in all affected societies that affects all sex and age groups, the type and severity of CL stigmata vary, however, and rely on several personal, sociopolitical and geopolitical determinant factors that may be common or different across societies. Available evidence shows that the key point of stigmatization in CL are the characteristic visible active lesions, scars and deformities that predominantly affect exposed, aesthetic parts of the body, in addition to fears and mistaken beliefs about CL nature and transmission methods. Mucosal lesions are more distressing than cutaneous lesions, active lesions than residual scars, DCL more than individual lesions and those on the prominent features more than those on the hidden parts are.The concurrent survey supports most of the concepts, implications and determinants of CLS introduced in this review. It concluded that the majority of Yemeni patients with active CL lesions or those carrying CL-related scars and deformities experience at least one type of CL-related stigmata considering them worse than the disease itself. Psychological type (CLPS) is the most prevalent form of CLS, followed by social (CLSS) and aesthetic (CLAS) types. Community-led initiatives such as ELYP and RLCC would significantly minimize the extensive impact CL stigmata have on patients’ lives.This report has introduced new ideologies upon stigmatizing process in CL and highlighted further types of CL-related stigmata, which might increase the understanding of that hidden dimension and enrich the global epidemiological profile of CL.
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https://www.researchgate.net/profile/Mohamed_Al-Kamel/publication/305610599_Stigmata_in_cutaneous_leishmaniasis_Historical_and_Stigmata_in_cutaneous_leishmaniasis_Historical_and_new_evidence-based_concepts/links/57e5a5d208ae9227da96573b.pdf