ŞARK ÇIBANI VAKALARINDA TEDAVİ TERK DURUMU VE NEDENLERİ

Year 2024, Volume: 9 Issue: 3, 313 - 322, 01.11.2024

Burcu Beyazgül , İbrahim Koruk , Ahmet Gündüzalp , Rüstem Kuzan , Şule Allahverdi

https://doi.org/10.35232/estudamhsd.1525348

Abstract

Bu çalışmanın amacı, Şanlıurfa Şark Çıbanı Tanı ve Tedavi Merkezi’nde tanısı konan ve tedaviye başlanan Kutanöz Layşmanyazis (KL) hastalarının; tedaviyi terk etme sıklığını saptamak ve tedaviyi terk etme nedenlerini belirlemektir. Araştırma tanımlayıcı tiptedir. Çalışmanın evrenini, 2020 yılında Şanlıurfa Şark Çıbanı Tanı ve Tedavi Merkezi’ne (ŞÇTTM) tanı ve tedavi amacıyla başvurup, KL tedavisine başlanan hastalar oluşturdu. Veri toplama aşaması 1 Temmuz 2020 – 31 Aralık 2020 tarihleri arasında gerçekleştirildi. Çalışmaya 1 Ocak 2020 tarihi itibariyle KL tanısı almış ve tedavi görmekte olan 370 hasta dahil edildi. Hastaların 187'sinin tedaviyi terk ettiği saptandı. Tedaviyi bırakma sıklığı %50,5 idi. Tedaviyi bırakanların %50,8'ini kadınlar oluşturdu. Tedaviyi bırakanların %3,7'sinin Türkçe bilmediği, %41,1'inin örgün eğitim almadığı saptandı. Tedaviyi bırakan hastaların %21,4’ü herhangi bir işte çalışmamaktadır ve %83,9'u alt sosyal sınıf ve işsiz grubunu oluşturmaktadır. Tedaviyi bırakanların %54,6'sı ilk kürü tamamlamadan tedaviyi bırakırken, %39,0'ı ilk kürü tamamladıktan sonra kontrol muayenesine gelmemiştir. Şark çıbanı olgularında en sık tedaviyi bırakma nedenleri; tedaviye ihtiyacı olmadığını düşünme (%28,9), önemsememe (%27,3) ve ŞÇTTM'de ilaç bulunmaması (%26,7) idi. Diğer nedenler ise COVID-19 pandemisi nedeniyle temas etmek istememe (%10,2), mevsimlik tarım işçiliği nedeniyle şehir dışında olmak (%5,9) olarak sıralandı. Bu çalışmada en sık tedaviyi bırakma nedenleri tedaviye ihtiyacı olmadığını düşünme, hastalığı önemsememe ve ilaç yetersizliği idi. KL vakalarının yoğun olduğu mahallelerde hastaların ve toplumun KL konusundaki bilgi ve farkındalığı artırılmalı, halk eğitim programları düzenlenmeli, SÇTTM'ye başvuran hastalar ve yakınları bilgilendirilmeli, tedaviyi tamamlamanın önemi anlatılmalıdır.

Keywords

Şark çıbanı, tedaviyi terk etme, tedaviyi bırakma, ihmal edilmiş tropikal hastalıklar

REASONS OF ABANDONMENT TREATMENT IN PATIENTS WITH LEISHMANIASIS

Abstract

The goals of this study that examined patients with Cutaneous Leishmaniasis (CL) who were diagnosed and treated at the Sanliurfa Cutaneous Leishmaniasis Diagnosis and Treatment Center (SCLDTC), were to determine the frequency of treatment discontinuation and the reasons for discontinuation. This was a descriptive study that included individuals who visited the SCLDTC for diagnosis and treatment in 2020 and were diagnosed with CL. The study’s data collection phase took place between July 1, 2020 and December 31, 2020. The study comprised 370 patients who were diagnosed with CL and under treatment as of January 1, 2020. It was found that 187 of these patients discontinued treatment. The frequency of treatment discontinuation was 50.5%. Of those who discontinued treatment, 50.8% were women. It was determined that 3.7% of those who discontinued treatment did not speak Turkish, and 41.1% had not received formal education. Among the patients who discontinued treatment, 21.4% had no job, and 83.9% belonged to the lower socioeconomic status and unemployed group. Of those who discontinued treatment, 54.6% stopped before completing the first course, while 39,0% did not attend the follow-up examination after completing the first course. In cases of cutaneous leishmaniasis, the most common reasons for discontinuing treatment were believing that they do not require treatment (28.9%), disregarding the disease (27.3%), and a lack of medication in SCLDTC (26.7%). In the present study, the most common reasons for discontinuing treatment were a lack of belief in the necessity for treatment, disregarding the disease, and a shortage of medication. Patients’ and society’s knowledge and awareness of CL should be increased, public education programs should be organized, patients admitted to SCLDTC and their relatives should be informed, and the importance of completing the treatment should be explained, especially in neighborhoods where CL cases are densely distributed.

Keywords

Leishmaniasis, treatment discontinuation, neglected tropical diseases

References

• World Health Organization. Neglected tropical diseases. 2020. Website https://www.who.int/data/gho/data/themes/neglected-tropical-diseases [cited 2020 Dec 15]
• World Health Organization. Leishmaniasis. 2020. Available form: https://www.who.int/news-room/fact-sheets/detail/leishmaniasis [cited 2020 Dec 15]
• World Health Organization. Control of the leishmaniases: report of a meeting of the WHO Expert Commitee on the Control of Leishmaniases, Geneva, 22-26 March 2010 [online]. Available form: https://apps.who.int/iris/handle/10665/44412 [cited 2020 Dec 15]
• Beyazgül B, Koruk İ, Barlas F. Epidemiology of Leishmaniasis Disease in Şanlıurfa Between the Years of 2010 and 2019. Namık Kemal Tıp Dergisi. 2023;11(4):308-13.
• Uzun S, Gürel M, Harman, M. Kutanöz Layşmanyazis Tanı ve Tedavi Rehberi. Türk Dermatoloji Derneği, İstanbul, Türkiye: Galenos Yayınevi; 2017.
• Beyazgül B, Koruk İ, Allahverdi Ş, Kuzan R. Psychosocıal And Socıodemographıc Factors That Affect Delays In Seekıng Treatment For Cutaneous Leıshmanıasıs In Sanlıurfa. Ponte; 2020:76(9).
• Minodier P, Parola P. Cutaneous leishmaniasis treatment. Travel Med Infect Dis. 2007;5:150-8.
• Hodiamont CJ, Kager PA, Bart A, de Vries HJ, van Thiel PP, Leenstra T, et al. Species-directed therapy for leishmaniasis in returning travellers: a comprehensive guide. PLoS Negl Trop Dis. 2014:8(5):e2832.
• Koruk İ, Beyazgül B, Allahverdi Ş, Kuzan R, Gökçeoğlu S. The State of Disease-Related Awareness Regarding Cutaneous Leishmaniasis Cases in Sanliurfa, Delay Level in Treatment and Reasons for Delay. Journal of Health Sciences of Adiyaman University. 2020:292-9.
• Centers for Disease Control and Prevention. Parasites - Leishmaniasis. 2020. Available form: https://www.cdc.gov/parasites/leishmaniasis/health_professionals/index.html#tx [cited 2020 Dec 15]
• Alizadeh I, Gorouhi MA, Sharifi I, et al . Risk Factors of Anthroponotic Cutaneous Leishmaniasis Among Residents in Endemic Communities in Southeast of Iran in 2019. J Environ Health Sustain Dev. 2021; 6(1): 1219 -30
• Irum S, Aftab M, Khan A, Naz S, Simsek S, Habib A, et al. Cutaneous Leishmaniasis (CL): A Cross-Sectional Community Based Survey on Knowledge, Attitude and Practices in a Highly Endemic Area of Waziristan (KPK Province) Pakistan. Acta Trop. 2021;213:105746.
• Yentür Doni N, Gürses G, Dikme R, Şimşek Z, Muratoğlu M, Yıldız Zeyrek F, et al. Investigation of cutaneous leishmaniasis by active screening in primary schools in Sanliurfa, Turkey. Mikrobiyol Bul. 2016;50(4):559-68.
• Bennis I, Belaid L, De Brouwere V, Filali H, Sahibi H, Boelaert M. The mosquitoes that destroy your face. Social impact of Cutaneous Leishmaniasis in South-eastern Morocco, A qualitative study. PLoS One. 2017;12(12):e0189906.
• Garapati P, Pal B, Siddiqui NA, Bimal S, Das P, Murti K, et al. Knowledge, stigma, health seeking behaviour and its determinants among patients with post kalaazar dermal leishmaniasis, Bihar, India. PloS one. 2018;13(9):e0203407.
• Bennis I, De Brouwere V, Belrhiti Z, Sahibi H, Boelaert M. Psychosocial burden of localised cutaneous Leishmaniasis: a scoping review. BMC Public Health. 2018;18(1):358.
• Uzun S, Durdu M, Culha G, Allahverdiyev AM, Memisoglu HR. Clinical features, epidemiology, and efficacy and safety of intralesional antimony treatment of cutaneous leishmaniasis: recent experience in Turkey. J Parasitol. 2004:90(4):853-9.
• Bamorovat M, Sharifi I, Agha Kuchak Afshari S, Karamoozian A, Tahmouresi A, Heshmatkhah A, et al. Poor adherence is a major barrier to the proper treatment of cutaneous leishmaniasis: A case-control field assessment in Iran. Int J Parasitol Drugs Drug Resist. 2023;21:21-7.
• Kansal S, Chakravarty J, Kumar A, Malaviya P, Boelaert M, et al. Risk Factors associated with defaulting from visceral leishmaniasis treatment: analysis under routine programme conditions in Bihar, India. Trop Med Int Health. 2017;22(8):1037-42.
• Garrido Mda S, Penna ML, Perez-Porcuna TM, de Souza AB, Marreiro Lda S, Albuquerque BC, et al. Factors associated with tuberculosis treatment default in an endemic area of the Brazilian Amazon: a case control-study. PLoS One. 2012;7(6):e39134.
• Shimels T, Asrat Kassu R, Bogale G, Bekele M, Getnet M, Getachew A, et al. Magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Ethiopia during the COVID-19 pandemic. PLoS One. 2021;16(4):e0249222.
• Jaimes Á, Rodríguez G. Cutaneous leishmaniasis and pregnancy. Biomedica. 2018;38(0):8-12.