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麻风病、皮肤利什曼病和恰加斯病患者的污名、参与限制和精神痛苦:哥伦比亚东部两个流行地区的初步研究。

Stigma, participation restriction and mental distress in patients affected by leprosy, cutaneous leishmaniasis and Chagas disease: a pilot study in two co-endemic regions of eastern Colombia.

机构信息

German Leprosy and TB Relief Association, DAHW América del Sur, Calle 128 B No. 56 C 05, Bogotá, Colombia.

NLR, Wibautstraat 137k, 1097 DN Amsterdam, the Netherlands.

出版信息

Trans R Soc Trop Med Hyg. 2020 Jul 1;114(7):476-482. doi: 10.1093/trstmh/trz132.

Abstract

BACKGROUND

Leprosy, cutaneous leishmaniasis (CL) and Chagas disease (CD) are neglected tropical diseases with a high psychosocial burden (PSB). These conditions are endemic in Norte de Santander and Arauca in Colombia, but data on the related PSB are scarce. Therefore, we assessed mental distress, participation restriction and stigma among CD, CL and leprosy patients.

METHODS

In 2018, 305 leprosy, CD or CL patients were interviewed using a self-report questionnaire to assess mental distress, participation scale for participation restriction and explanatory model interview catalogue (EMIC) for stigma. Descriptive statistics and the significance of median score differences were compared.

RESULTS

Fifty percent of CD patients and 49% of leprosy patients exhibited mental distress, percentages which were significantly higher than that of CL (26%). Twenty-seven percent of leprosy patients experienced participation restriction, which was lower for CL (6%) and CD (12%). Median EMIC scores were significantly higher for leprosy patients than for CD (27%) and CL (17%) patients.

CONCLUSIONS

We found high levels of PSB among leprosy, CD and CL patients. Mental distress was highest among CD patients. Participation restriction and stigma were more prevalent in leprosy patients. Rural residence or lower educational status may impact PSB. Further investigation is needed to formulate evidence-based, holistic interventions.

摘要

背景

麻风病、皮肤利什曼病(CL)和恰加斯病(CD)是具有高心理社会负担(PSB)的被忽视热带病。这些疾病在哥伦比亚的北桑坦德和阿劳卡流行,但与相关 PSB 相关的数据却很少。因此,我们评估了 CD、CL 和麻风病患者的精神困扰、参与受限和耻辱感。

方法

2018 年,对 305 名麻风病、CD 或 CL 患者进行了访谈,使用自我报告问卷评估精神困扰、参与受限量表和解释性模型访谈目录(EMIC)评估耻辱感。比较了描述性统计数据和中位数评分差异的显著性。

结果

50%的 CD 患者和 49%的麻风病患者存在精神困扰,这两个百分比显著高于 CL(26%)患者。27%的麻风病患者存在参与受限,CL(6%)和 CD(12%)患者的比例较低。麻风病患者的 EMIC 评分中位数明显高于 CD(27%)和 CL(17%)患者。

结论

我们发现麻风病、CD 和 CL 患者的 PSB 水平较高。CD 患者的精神困扰最高。参与受限和耻辱感在麻风病患者中更为普遍。农村居住或较低的教育程度可能会影响 PSB。需要进一步调查以制定基于证据的整体干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f34/7334822/445c9ed76522/trz132f1.jpg

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