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Trans R Soc Trop Med Hyg. 2020 Feb 13. pii: trz132. doi: 10.1093/trstmh/trz132. [Epub ahead of print]

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.

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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.
Francisco de Paula Santander University, 12E96 Avenida Gran Colombia, Cúcuta, Colombia.
Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands.
German Leprosy and TB Relief Association, Raiffeisenstraße 3, 97080 Würzburg, Germany.
Global Health-Disaster Medicine, Medical School, National and Kapodistrian University of Athens, Mikras Asias 17, Athens, 115 27, Greece.



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.


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.


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.


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.


Chagas disease; cutaneous leishmaniasis; leprosy; mental health; social participation; stigmatization


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