Perception and use of Medicinal Plants and Chemical Products in the Traditional Treatment of Cutaneous Leishmaniasis in Morocco

Abstract

Cutaneous leishmaniasis is a neglected skin disease that poses a serious health problem in many countries including Morocco. Although treatment is free of charge at state health facilities, there is under-utilization of health services by patients. The objective is to know and understand the obstacles faced by people with cutaneous leishmaniasis when seeking anti-Leishmania treatment. Qualitative study was conducted among people affected by cutaneous leishmaniasis in central Morocco in rural communes in the province of El Hajeb. In-depth individual interviews were conducted and transcribed verbatim. A thematic analysis was used to process and present these data. In total, fourteen people with cutaneous leishmaniasis were recruited with an average age of 45 years, 78.6 % of whom lived in rural areas. Four main themes emerged from the data analysis: (1) Perception of the disease and trivialization of skin lesions; (2) Popular treatmentseeking behavior; (3) Gender and decision to seek treatment; (4) Therapeutic preferences and refusal of injection. This research showed that patients did not seek medical treatment for their disease until the lesions persisted despite the application of traditional remedies. Socio-cultural aspects were the most important factors preventing patients from seeking and receiving timely medical care. The female gender was a determinant for seeking health care from caregivers. The trivialization of skin lesions and the use of traditional practices were socio-cultural factors limiting the use of medical treatment by those affected. These factors, together with the fear of pain caused by the injection, were the decisive point for abandoning anti-Leishmania treatment.