Abstract:
Background: Leishmaniasis is a vector-borne disease caused by an obligate intracellular protozoan of the genus Leishmania, and transmitted by bites of infected female sandflies. Global data revealed that the prevalence of cutaneous leishmaniasis ranges from 5.9% to 51%. In Ethiopia, cutaneous leishmaniasis prevalence ranges from 2.3% to 66%. Cutaneous leishmaniasis can manifest as localized cutaneous leishmaniasis, which can ulcerate and heal leaving depressive scars that can result in a sort of aesthetic stigmata, especially in young women (gender stigma); however, data which shows the burden and impact of the disease in this area is limited. A population-based prevalence and the level of stigma among infected individuals are worth investigating to initiate evidence-based intervention.
Objective: The aim of this study is to assess the prevalence, level of stigma, and associated factors of cutaneous leishmaniasis among suspected population living in Dega Damot district, Northwest Ethiopia.
Methods: A community-based cross-sectional study was conducted on 205 cutaneous leishmaniasis suspected participants recruited via a random sampling technique in five cutaneous leishmaniasis reported kebeles of the Dega Damot district from May to June 2022. Laboratory confirmation was done via microscopic smear and Novy-MacNealNicolle culture. The level of stigma was measured based on the Dermatology Life Quality Index scale. Data entry and analysis were conducted using SPSS version 20. The association between different variables in relation to the outcome variable was measured by the odds ratio at a 95% confidence interval. All variables with P <0.20 in the bivariate analysis were included in the multivariate model, accepting P < 0.05 as statistically significant.
Results: The prevalence of cutaneous leishmaniasis in this study was 28.3%. The mean stigma score was found to be 17.2 ranging from 2 to 26. In the multivariate analysis, sex (AOR=3, 95% CI: 1.2-7.6), outdoor sleeping (AOR=3.4, 95% CI: 1.3-9.3), housing condition (grass thatched roofs with cracked walls) (AOR=3.2, 95%CI: 1.4-7.2), presence of hyraxes (AOR= 2.8, 95%CI: 1.2-6.5), Acacia tree (AOR= 6.8, 95%CI: 1.7-27.2) and gorges (AOR=5.6, 95%CI: 2.1-15.0) were significant predictors of developing cutaneous leishmaniasis.
Conclusion: The overall prevalence of cutaneous leishmaniasis in the study area was high, and the level of stigma was very large. Thus, Overall, preventive and control methods should be sought, including the treatment center in the nearby Feresbet primary hospital.
Key words: Cutaneous leishmaniasis, Dega Damot, Ethiopia, prevalence, stigma