Constraints and Challenges of Local Operationalization of the National Leishmaniasis Control Program by Health Professionals: A Pioneer Study in Morocco

Abstract

Background: This research aims to assess the knowledge of health pro- fessionals on leishmaniasis to determine the strengths and weaknesses in the control activities of these parasitoses at the local level and to identify the causes that are likely to lead to underreporting of cases. Also, this study is presented to unveil the knowledge of health professionals about leishman- iasis and explore their role in the peripheral management of the program and their experiences with leishmaniasis patients Morocco aims to be leishmaniasis-free by 2030. These disorders can be cutaneous or visceral, and they are a severe public health issue. The fight against these parasites is carried out as part of a nationwide leishmaniasis control programme that provides free treatment. The screening rate in public health structures, on the other hand, does not reach 35%.

Objective: Determine the knowledge and experience of social actors directly involved in the fight against leishmaniasis in order to contribute to the analysis and understanding of the factors that contribute to underreporting and the development of scientific recommendations to improve leishmaniasis screening and control activities.

Methods: Using a self-administered questionnaire, we conducted an exploratory survey during April and May 2019 among all health professionals working in public health structures in the province of ELHajeb in central Morocco.

Results: We found that most of the health professionals had good knowledge about the clinical signs of each form of leishmaniasis, but they had erroneous information about the true vector of the disease, the reservoirs, and the mode of transmission. 76% recognized the national leishmaniases control program and only 17% received continuing education. 85% of these professionals focused on the curative aspects of the program. 47% stated that patients do not adhere to the antileishmaniasis treatment, and 25% stated that the population uses the concept of “Hboub of Chniwla” to refer to cutaneous leishmaniasis.

Conclusion: The study concluded that the operationalization of the activities of the leishmaniases control program recognizes some weaknesses which explain the underscreening of cases. Improvement of this situation requires the implementation of continuous training programs for caregivers and awareness-raising programs for citizens which should focus on the mode of transmission, preventive measures against reservoirs, sand flies bites, and recognition of lesions using the popular names of the disease as a starting point.