Authors

H Price¹; S Agampodi²; TC Agampodi²; L Dikomitis³; PR Machado⁴; A Mulugeta⁵; L Trad⁴;  ¹ Keele University, UK;  ² Rajarata University of Sri Lanka, Sri Lanka;  ³ Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, Canterbury, UK;  ⁴ Federal University of Bahia, Brazil;  ⁵ Mekelle University, Ethiopia

Discussion

ECLIPSE is a five-year applied healthcare programme which aims to improve the patient journey and reduce stigma for people living with cutaneous leishmaniasis (CL) in the most underserved communities in Brazil, Ethiopia and Sri Lanka. ECLIPSE brings together leishmaniasis expertise in an international, cross-cultural, multidisciplinary team of over 60 researchers, including anthropologists, parasitologists, clinicians from different medical specialties, psychologists, disease specialist and public health researchers. We have used a range of qualitative and quantitative methods to gain in-depth understanding of people, communities and healthcare professionals' experiences and views on the effects of CL on the daily lives of those affected, the barriers to seeking healthcare, obtaining accurate, early diagnosis and receiving effective treatment.

Here we present findings on the many challenges to accessing diagnosis and treatments for CL in our field sites, within the context of the COVID-19 pandemic and the conflict in Tigray, Ethiopia. Multiple injections of pentavalent antimonials remain the most common biomedical treatment for CL and are predominantly delivered in tertiary-level healthcare facilities. There are multiple barriers to accesssing healthcare for CL, including lack of awareness of the disease (in both community members and healthcare professionals), the need to travel long distances, cost, fear of side-effects, loss of earnings during treatment and caring responsibilities. Self-treatment and the use of traditional remedies are very common, particularly in sites where there is poor access to biomedical treatment. We discuss recommendations to improve the patient journey for people living with this highly neglected disease.