02578nas a2200289 4500000000100000008004100001653001200042653001300054653002600067653001000093653002800103653003900131653001400170653001100184100001300195700001100208700001300219700001800232700001300250700001500263245012100278856007600399300000700475490000600482520178600488022001402274 2017 d10aMorocco10aStudents10aPsycho-social aspects10aScars10aCutaneous leishmaniasis10aNeglected tropical diseases (NTDs)10aTreatment10aStigma1 aBennis I1 aThys S1 aFilali H1 aDe Brouwere V1 aSahibi H1 aBoelaert M00aPsychosocial impact of scars due to cutaneous leishmaniasis on high school students in Errachidia province, Morocco. uhttps://idpjournal.biomedcentral.com/articles/10.1186/s40249-017-0267-5 a460 v63 a

BACKGROUND: In Morocco, cutaneous leishmaniasis (CL) is usually known to be a slowly healing localized skin disease, but in some cases, it can lead to mutilating scars. The outbreak of CL due to Leishmania major in the Errachidia province in southeastern Morocco between 2008 and 2010 left many adolescents with permanent scar tissue on the face or other exposed body parts. We studied the psychosocial impact of CL on these young people.

METHODS: In 2015 we conducted a cross-sectional survey among high-school students living in boarding schools in two CL-endemic areas of Errachidia: Rissani and Tinejdad. A self-administered questionnaire elicited responses about general knowledge of CL and related scars. An open-ended question focused on the possible psychosocial effects associated with these scars. The quantitative data were analyzed with Epi Info™ and the text data with NVivo software.

RESULTS: Almost 20% of 448 respondents reported they had experienced a CL lesion and 87% said it could possibly or definitely lead to psychological consequences. The text analysis showed that girls more often than boys expanded on the negative psychological effects of CL. The students considered CL as "dangerous", "serious", and "deathly", and said it sometimes led to extreme suicidal ideations.

CONCLUSIONS: The burden of CL in this age group is not negligible. The indelible CL scars lead to self-stigma and social stigma, and the emergence of negative psychological effects in this age group. While some students accepted their CL scars and related suffering as their "destiny", others were eagerly demanding protective measures against CL and treatment for the scars.

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