Stigmatizing neglected tropical diseases: a systematic review

Abstract

he Neglected Tropical Diseases (NTDs) are the most common infections of poor people in developing countries, where they cause severe and permanent disabilities and a high disease burden. The stigma associated with disfiguring NTDs such as Buruli ulcer, leprosy, onchocerciasis, lymphatic filariasis and cutaneous leishmaniasis, have important psycho-social effects in affected communities and has only been partly analyzed in the literature. Objective: The present article will review literature on stigma associated with cutaneous NTDs, explore the public health implications of stigma, and suggest a comprehensive approach to this cluster of diseases. Methodology/Principal findings: A literature review was done using the following datasets: PUBMED, Google Scholar, SCIELO, LILACS, and MEDLINE. Furthermore, a web search was conducted on the WHO website. Eighty three articles were found on our topic of interest. Eighty of them were related to cutaneous disfiguring NTDs; twenty had a qualitative approach. Our findings show that stigma is associated with all five cutaneous NTDs and causes remarkable psychological and public health consequences. Gender differences with regard to stigma are also considered. Conclusions: Stigma associated with disfiguring NTDs has been shown to be a major factor influencing access to health services and treatment adherence. If effective programs are to be successfully implemented, appropriate interventions are needed to prevent stigma and eliminate its negative effects. Although lymphatic filariasis and leprosy tend to show a broader research coverage of socio-cultural and psychological aspects of the disease, further research on other cutaneous stigmatizing neglected tropical is urgently needed. The literature suggests that stigma should be addressed in joint interventions rather than one disease at a time.