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Journal of Tropical Medicine
Volume 2013, Article ID 538629, 10 pages
http://dx.doi.org/10.1155/2013/538629
Research Article

Mucocutaneous Leishmaniasis: Knowledge, Attitudes, and Practices Among Paraguayan Communities, Patients, and Health Professionals

1Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Ciencias Sociales, 1120 Asunción, Paraguay
2Universidad Nacional de Asunción, Instituto de Investigaciones en Ciencias de la Salud, Departamento de Producción-Bioquímica, 1120 Asunción, Paraguay
3London School of Hygiene and Tropical Medicine, Faculty of Infectious and Tropical Diseases, Department of Pathogen Molecular Biology, Keppel Street, London WC1E 7HT, UK
4Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
5Faculty of Tropical and Infectious Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
6University of Alberta, School of Public Health, Edmonton, AB, Canada T6G 2T4

Received 10 January 2013; Accepted 3 March 2013

Academic Editor: Shyam Sundar

Copyright © 2013 Mónica Ruoti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (MCL) due to Leishmania (V.) braziliensis are endemic in Paraguay. We performed a series of knowledge, attitudes, and practice (KAP) surveys simultaneously with individuals in endemic communities in San Pedro department ( ), health professionals ( ), and patients ( ). Results showed that communities were exposed to high risk factors for transmission of L. braziliensis. In logistic regression analysis, age was the only factor independently associated with having seen a CL/MCL lesion ( ). The pervasive attitude in communities was that CL was not a problem. Treatment seeking was often delayed, partly due to secondary costs, and inappropriate remedies were applied. Several important cost-effective measures are indicated that may improve control of CL. Community awareness could be enhanced through existing community structures. Free supply of specific drugs should continue but ancillary support could be considered. Health professionals require routine and standardised provision of diagnosis and treatment algorithms for CL and MCL. During treatment, all patients could be given simple information to increase awareness in the community.