Tora Abebayehu, Mengiste Asrat, Davey Gail, Semrau Maya
Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia.
National Podoconiosis Action Network, Addis Ababa, Ethiopia.
Trop Med Infect Dis. 2018 Aug 16;3(3):87. doi: 10.3390/tropicalmed3030087.
Podoconiosis is a neglected tropical disease (NTD) characterized by lower-leg swelling (lymphedema), which is caused by long-term exposure to irritant red-clay soils found within tropical volcanic high-altitude environments with heavy rainfall. The condition places a substantial burden on affected people, their families and communities, including disability, economic consequences, social exclusion, and stigma; mental disorders and distress are also common. This paper focuses on community-based care of podoconiosis, and, in particular, the role that community involvement can have in the reduction of stigma against people affected by podoconiosis. We first draw on research conducted in Ethiopia for this, which has included community-based provision of care and treatment, education, and awareness-raising, and socioeconomic rehabilitation to reduce stigma. Since people affected by podoconiosis and other skin NTDs often suffer the double burden of mental-health illness, which is similarly stigmatized, we then point to examples from the mental-health field in low-resource community settings to suggest avenues for stigma reduction and increased patient engagement that may be relevant across a range of skin NTDs, though further research is needed on this.
足分枝菌病是一种被忽视的热带病，其特征为小腿肿胀（淋巴水肿），病因是长期接触热带火山高海拔、降雨量大环境中存在的刺激性红黏土。这种疾病给患者及其家庭和社区带来沉重负担，包括残疾、经济后果、社会排斥和耻辱感；精神障碍和痛苦也很常见。本文聚焦于足分枝菌病的社区护理，特别是社区参与在减少对足分枝菌病患者耻辱感方面所能发挥的作用。为此，我们首先借鉴在埃塞俄比亚开展的研究，其中包括基于社区的护理与治疗、教育及提高认识，以及社会经济康复以减少耻辱感。由于足分枝菌病和其他皮肤性热带病患者常常承受同样遭受耻辱的心理健康疾病的双重负担，我们接着列举资源匮乏社区环境中心理健康领域的实例，以提出减少耻辱感和提高患者参与度的途径，这些途径可能适用于一系列皮肤性热带病，不过对此还需要进一步研究。
