Psychological and Psychosocial Consequences of Zoonotic Cutaneous Leishmaniasis among Women in Tunisia: Preliminary Findings from an Exploratory Study

Background The incidence of zoonotic cutaneous leishmaniasis (ZCL) makes it the most widespread parasitic disease in Tunisia and the Arab world. Yet, few studies have addressed its psychological and psychosocial effects. The purpose of this study was to examine the psychosocial impact of ZCL scars among Tunisian women. Methods We conducted an exploratory study, we administered Revised Illness Perception Questionnaire (IPQ-R), World Health Organization Quality Of Life-26 (WHOQOL-26) and Psoriasis Life Stress Inventory (PLSI) to a group of girls and women with ZCL scar in the region of Sidi Bouzid. This group was randomly selected from volunteers who came to primary health care facilities to seek for treatment for any pathology. Results Descriptive statistics showed that the collected scores from the three scales exhibit heterogeneous distributions: IPQ-R (M = 63.6, SD = 15.6), PSLI (M = 9.5, SD = 6.7), WHOQOL-Physical (M = 63, SD = 12.9), WHOQOL-Psychological (M = 52.6, SD = 11.1), WHOQOL-Social (M = 61.8, SD = 17.5), and WHOQOL-Environmental (M = 47.8, SD = 13.3). The correlation analyses performed on Inter and intra-subscales showed that the emotional representations associated with ZCL were correlated with the loss of self-esteem and feelings of inferiority (r = 0.77, p<0.05). In addition, high education level and the knowledge about ZCL are positively correlated with cognitive and emotional representation in the IPQ-R (r = 0.33, p<0.05). "Rejection experiences" and the "anticipation and avoidance of stress" were respectively negatively correlated with age (r = -0.33, p<0.05 and r = -0.31, p<0.05). Correlations between the scores on IPQ-R domains and PLSI factors were significant. The results showed that anticipation of rejection and avoidance of stress are strongly correlated with a negative perception of ZCL. Quality of life scores were not correlated with either age, education level, time of illness, or the number of facial or body scars. However, the correlations between quality of life scores and the multiple IPQ-R domains were all insignificant. Finally, there was a negative correlation between the scores on the perceived quality of social life and the knowledge about ZCL (r = -0.34, p<0.05). Conclusions This makes it vital to strengthen preventive health education. Conducting studies on ways to establish a holistic support system for managing ZCL, a system that covers the psychological challenges and the barriers it causes to women’s social and professional integration, is a vital first step

Analysis of the farmer's behaviors and the risk of exposure to the vector of Zoonotic cutaneous leishmaniasis in Tunisia

The research shows that behaviour of farmers in relation to irrigation is imposed by the nature of the agricultural activity, by the hydraulic system, and by the method of irrigation. A mathematical model is used to calculate risk of exposure to Zoonotic Cutaneous Leishmaniasis (ZCL). Farmers in the El Hichria (Tunisia) irrigated perimeter (IP) use water distributed by surface canals. In the Ouled Mhamed IP, underground pressurized water pipes bring water to irrigation terminals. The farmers are exposed to the risk of contact with the Phlebotomus papatasi, a vector of ZCL, of 0.25 on a scale of 1, associated with irrigation

Su(3) Symmetry in a Bootstrap Model

Transmission of zoonotic cutaneous leishmaniasis (ZCL) depends on the presence, density and distribution of Leishmania major rodent reservoir and the development of these rodents is known to have a significant dependence on environmental and climate factors. ZCL in Tunisia is one of the most common forms of leishmaniasis. The aim of this paper was to build a regression model of ZCL cases to identify the relationship between ZCL occurrence and possible risk factors, and to develop a predicting model for ZCL's control and prevention purposes. Monthly reported ZCL cases, environmental and bioclimatic data were collected over 6 years (2009-2015). Three rural areas in the governorate of Sidi Bouzid were selected as the study area. Cross-correlation analysis was used to identify the relevant lagged effects of possible risk factors, associated with ZCL cases. Non-parametric modeling techniques known as generalized additive model (GAM) and generalized additive mixed models (GAMM) were applied in this work. These techniques have the ability to approximate the relationship between the predictors (inputs) and the response variable (output), and express the relationship mathematically. The goodness-of-fit of the constructed model was determined by Generalized cross-validation (GCV) score and residual test. There were a total of 1019 notified ZCL cases from July 2009 to June 2015. The results showed seasonal distribution of reported ZCL cases from August to January. The model highlighted that rodent density, average temperature, cumulative rainfall and average relative humidity, with different time lags, all play role in sustaining and increasing the ZCL incidence. The GAMM model could be applied to predict the occurrence of ZCL in central Tunisia and could help for the establishment of an early warning system to control and prevent ZCL in central Tunisia

Monitoring and Evaluating Progress towards Universal Health Coverage in Tunisia

<p>Monitoring and Evaluating Progress towards Universal Health Coverage in Tunisia</p

Chronic disease (hypertension and diabetes) trends [6].

<p>Chronic disease (hypertension and diabetes) trends <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001729#pmed.1001729-Anonymous2" target="_blank">[6]</a>.</p

[Evaluation of the surveillance of invasive meningococcal disease in Tunisia: capture-recapture method].

International audienceThe objective of this study was to assess the completeness of the epidemiological surveillance system for invasive meningococcal diseases in greater Tunis.A six-year retrospective study (2003-2008) identified all cases of invasive meningococcal disease reported on Mandatory Notification records of the Tunis Regional Department of Health and those reported by the Tunis Children's hospital microbiology laboratory, considered to be the main source of diagnoses of invasive meningococcal disease in Greater Tunis. The "capture-recapture" method was applied. Thirty-eight cases of invasive meningococcal disease reported to the Regional Department of Health and 47 cases provided by the children's hospital were analysed during the study period and 25 cases common to both sources were identified. The total number of cases of invasive meningococcal disease was estimated to be 71 (95% CI = [60-82]), using the capture-recapture method. Completeness rates were 53.5% (95% CI = [46.6 to 62.9]) for Mandatory Notification to the Regional Department of Health and 66.2% (95% CI = [57.6 to 77.8]) for children's hospital. Stratified analyses suggest that the two data sources were probably independent. The capture-recapture method applied to the invasive meningococcal disease surveillance system in Greater Tunis showed a poor sensitivity of the Mandatory Notification. Factors influencing under-reporting of cases should be identified to improve this surveillance

Study area.

<p>(A) Location of Tunisia within the Mediterranean basin, (B) Location of Sidi Bouzid gouvernorate within Tunisia, (C) Location of the study areas (Bir Badr and Hichria).</p

Relationship between illness perception, stress, and stigma.

<p>Relationship between illness perception, stress, and stigma.</p

Distribution of the scores on the IPQ-R, PSLI and Whoqol different domains.

<p>Distribution of the scores on the IPQ-R, PSLI and Whoqol different domains.</p

Relationships between quality of social life and anticipation and avoidance of stress score.

<p>Relationships between quality of social life and anticipation and avoidance of stress score.</p