Abstract
Cutaneous Leishmaniasis (CL) is a disease caused by the parasite “Leishmania” and is endemic in more than 90 countries of the world. Despite its vast prevalence and impact on quality of life (qol), it is one of the most neglected tropical dermatological diseases. The patients face considerable mental challenges including anxiety, depression and low self-esteem, leading to a low qol. This study aims to determine the effect of CL on qol of patients suffering from it. It is a cross-sectional study that evaluated 212 patients suffering from CL who reported at Pak Emirates Military Hospital (PEMH), Rawalpindi, Combined Military Hospital (CMH), Peshawar, PNS Shifa, Karachi and CMH, Quetta from September 2018 to March 2019. For measuring the qol, Dermatology Life Quality Index (DLQI) questionnaire was filled in voluntarily. Data on demographics and characteristics of the lesions was also collected and analyzed using SPSS 22 software. DLQI scores ranged from 0 to 29 out of a total of 30 with a mean score of 14.01±7.5. The patients were divided into five categories based on the impact the disease had on them according to the scores obtained; 74 (35%) were those who had a large effect and only six (3%) had no effect. “Feelings” was the most affected area (mean 2.10±0.94) followed by work (1.64±1.23) and sexual function had the least effect (mean 0.86±1.04). CL was found to have a significant effect on qol of 180 (85%) of the patients. A statistically significant association was seen between type, size and duration of lesions and patient’s qol. Therefore, CL significantly influences the quality of life of patients. The ulcerated type, longer duration and larger size of the lesion had greater impact on the quality of life. Preventive measures should be taken to reduce the prevalence of the disease and hence, improve the qol of people in the endemic areas.
Highlights
Cutaneous Leishmaniasis is a disease caused by the parasite “Leishmania” transmitted by bite of Phlebotomine Sand-fly
[4] Despite its vast prevalence and impact on quality of life, it is one of the most neglected tropical dermatological diseases. [5, 6] The main reason behind it is the low mortality rate associated with Cutaneous Leishmaniasis (CL)
After approval from institutional ethical review committee, a cross-sectional analytical study was conducted at the Dermatology Department, Pak Emirates Military Hospital (PEMH) Rawalpindi, Combined Military Hospital (CMH) Peshawar, CMH Quetta and PNS Shifa, Karachi for a duration of 6 months from September 2018 to March 2019
Summary
Cutaneous Leishmaniasis is a disease caused by the parasite “Leishmania” transmitted by bite of Phlebotomine Sand-fly. [4] Despite its vast prevalence and impact on quality of life, it is one of the most neglected tropical dermatological diseases. [7] CL has four major forms of clinical presentation; papule, nodule, nodular ulceration and plaque. It may heal spontaneously but takes a long time and leaves disfiguring scars that have a great degree of stigmatization associated with it. [8] The patients face severe mental challenges including anxiety, depression and low self-esteem, leading to a low quality of life, as seen in other disfiguring neglected tropical diseases. [9,10,11] currently, no such study exists in Pakistan to assess the effect on qol of these patients. DLQI is a well reputed and time tested tool for its validity and reliability to determine the effect of chronic dermatological diseases on qol. [12] our study will be a useful contribution to study the effect of CL on qol of our population
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