Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka.
Centre for Health Services Studies and Kent and Medway Medical School, University of Kent, Canterbury, UK.
Int Health. 2024 Sep 5;16(5):553-561. doi: 10.1093/inthealth/ihae021.
There is limited knowledge about the stigma associated with cutaneous leishmaniasis (CL) in Sri Lanka. To ensure that leishmaniasis researchers focus on CL-associated stigma, we provide an evidence-based framework that can be used in future research.
We conducted a systematic review on CL-associated stigma using international evidence and carried out a multimethod qualitative study in the Anuradhapura district in Sri Lanka. Based on that, we identified manifestations of stigma, drivers and facilitators that we synthesised to develop a conceptual framework on CL-associated stigma.
Our framework consists of drivers, facilitators and self-stigma experienced by people with CL. Stigma drivers included fear, misbeliefs and misconceptions about CL; the belief that wounds are disfiguring; the treatment burden and implied blame. Facilitators that reduced stigma included knowledge of the curability of CL and awareness that CL is not contagious. The nature of social interactions in rural communities enhanced stigma formation. We identified various enacted, felt and internalised stigma experiences of people with CL.
We developed a conceptual framework of the stigma associated with CL that can be used to develop targeted interventions to increase CL awareness, address stigma and improve the quality of life for CL patients.
斯里兰卡对皮肤利什曼病（CL）相关污名知之甚少。为确保利什曼病研究人员关注 CL 相关污名，我们提供了一个基于证据的框架，可用于未来的研究。
我们使用国际证据对 CL 相关污名进行了系统评价，并在斯里兰卡的阿努拉德普勒区进行了多方法定性研究。在此基础上，我们确定了污名的表现形式、驱动因素和促成因素，我们对其进行了综合分析，以制定一个关于 CL 相关污名的概念框架。
我们的框架包括 CL 患者的污名驱动因素、促成因素和自我污名。污名驱动因素包括对 CL 的恐惧、误解和误解；认为伤口会毁容；治疗负担和隐含的指责。减轻污名的促成因素包括对 CL 可治愈性的了解以及对 CL 不具有传染性的认识。农村社区中社会互动的性质增强了污名的形成。我们确定了 CL 患者的各种表现、感觉和内化的污名体验。
我们开发了一个与 CL 相关污名的概念框架，可用于制定有针对性的干预措施，以提高 CL 意识，解决污名问题，提高 CL 患者的生活质量。
