Addressing Behavioural Determinants of Cutaneous Leishmaniasis Through Community Dialogue in Kalu District, Ethiopia: A Mixed‐Methods Study
10 affiliations
- 1School of Public Health, St. Paul's Hospital Millennium Medical College Addis Ababa Ethiopia
- 2School of Public Health, College of Health Sciences Addis Ababa University Addis Ababa Ethiopia
- 3Armauer Hansen Research Institute Addis Ababa Ethiopia
- 4Department of Clinical Research, Faculty of Infectious and Tropical Diseases London School of Hygiene & Tropical Medicine London UK
- 5Department of Global Health and Development, Faculty of Public Health and Policy London School of Hygiene & Tropical Medicine London UK
- 6African Population and Health Research Centre Nairobi Kenya
- 7Dessie Health Sciences College Dessie Amhara Regional State Ethiopia
- 8Department of Health Informatics, College of Medicine and Health Sciences Mettu University Mettu Ethiopia
- 9Hospital for Tropical Diseases University College London Hospital London UK
- 10Division of Infection and Immunity University College London London UK
Abstract
Background: Cutaneous leishmaniasis (CL) is a major public health challenge in Ethiopia, with 20–30,000 new cases annually. Limited awareness and misconceptions contribute to delayed care seeking, stigma, prolonged healing, and reduced uptake of preventive measures in CL‐endemic communities. To address these challenges, a participatory community dialogue (CD) intervention was implemented to evaluate a structured CD intervention in improving knowledge, attitudes, and preventive practices related to CL in Kalu District, Ethiopia.
Methods: A convergent parallel mixed‐methods study was conducted in three CL‐endemic clusters. Structured CD sessions were held between May and September 2024. Post‐intervention qualitative data were collected through in‐depth interviews with facilitators and mobilisers (n = 6) and 10 focus group discussions with participants (n = 81), analysed thematically. Quantitative data were obtained from questionnaires before (n = 128) and after the intervention (n = 109), compared using paired t‐tests and odds ratios.
Results: Participants in group discussions explained that CD sessions helped them to abandon misconceptions, such as beliefs that CL is transmitted through bat urine and that CL‐affected people need to self‐isolate during treatment to avoid contacts with those who had sexual intercourse and might cast a ‘shadow’ that could harm their healing. The intervention reframed contagion fears and encouraged biomedical explanations. Questionnaire data indicated attribution of CL to ‘germs/parasites’ increased from 21% (27/128) before the CD to 88% (96/109) after the CD and belief in self‐isolation declined from 61% (78/128) to 8% (9/109). Perceptions of CL as preventable and treatable at health facilities increased, with modest improvements in preventive practices.
Conclusions: The CD intervention addressed behavioural determinants of CL by improving knowledge, reducing misconceptions, and encouraging timely care seeking. It reduced shadow‐related isolation beliefs and increased correct causal attribution, underscoring its potential to strengthen CL control in endemic settings. Integrating participatory approaches into public health strategies offers a pathway to sustain behavioural change.
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BibTeX
@article{demie2026addressing,
title = {{Addressing Behavioural Determinants of Cutaneous Leishmaniasis Through Community Dialogue in Kalu District, Ethiopia: A Mixed‐Methods Study}},
author = {Takele Gezahegn Demie and Tara Mtuy and Jennifer Palmer and Eshetu Girma and Yohannes Hailemichael and Teklu Cherkose and Telahun Kasa Tefera and Mohammedjud Hassen Ahmed and Catherine Pitt and Michael Marks and Stephen L. Walker and Endalamaw Gadisa and Mirgissa Kaba and SHARP collaboration},
journal = {Tropical Medicine \& International Health},
year = {2026},
month = jul,
doi = {10.1111/tmi.70194},
url = {https://doi.org/10.1111/tmi.70194},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Addressing Behavioural Determinants of Cutaneous Leishmaniasis Through Community Dialogue in Kalu District, Ethiopia: A Mixed‐Methods Study
AU - Takele Gezahegn Demie
AU - Tara Mtuy
AU - Jennifer Palmer
AU - Eshetu Girma
AU - Yohannes Hailemichael
AU - Teklu Cherkose
AU - Telahun Kasa Tefera
AU - Mohammedjud Hassen Ahmed
AU - Catherine Pitt
AU - Michael Marks
AU - Stephen L. Walker
AU - Endalamaw Gadisa
AU - Mirgissa Kaba
AU - SHARP collaboration
PY - 2026
DA - 2026/07/16
JO - Tropical Medicine & International Health
DO - 10.1111/tmi.70194
UR - https://doi.org/10.1111/tmi.70194
AB - Background: Cutaneous leishmaniasis (CL) is a major public health challenge in Ethiopia, with 20–30,000 new cases annually. Limited awareness and misconceptions contribute to delayed care seeking, stigma, prolonged healing, and reduced uptake of preventive measures in CL‐endemic communities. To address these challenges, a participatory community dialogue (CD) intervention was implemented to evaluate a structured CD intervention in improving knowledge, attitudes, and preventive practices related to CL in Kalu District, Ethiopia. Methods: A convergent parallel mixed‐methods study was conducted in three CL‐endemic clusters. Structured CD sessions were held between May and September 2024. Post‐intervention qualitative data were collected through in‐depth interviews with facilitators and mobilisers (n = 6) and 10 focus group discussions with participants (n = 81), analysed thematically. Quantitative data were obtained from questionnaires before (n = 128) and after the intervention (n = 109), compared using paired t‐tests and odds ratios. Results: Participants in group discussions explained that CD sessions helped them to abandon misconceptions, such as beliefs that CL is transmitted through bat urine and that CL‐affected people need to self‐isolate during treatment to avoid contacts with those who had sexual intercourse and might cast a ‘shadow’ that could harm their healing. The intervention reframed contagion fears and encouraged biomedical explanations. Questionnaire data indicated attribution of CL to ‘germs/parasites’ increased from 21% (27/128) before the CD to 88% (96/109) after the CD and belief in self‐isolation declined from 61% (78/128) to 8% (9/109). Perceptions of CL as preventable and treatable at health facilities increased, with modest improvements in preventive practices. Conclusions: The CD intervention addressed behavioural determinants of CL by improving knowledge, reducing misconceptions, and encouraging timely care seeking. It reduced shadow‐related isolation beliefs and increased correct causal attribution, underscoring its potential to strengthen CL control in endemic settings. Integrating participatory approaches into public health strategies offers a pathway to sustain behavioural change.
SN - 1360-2276
SN - 1365-3156
ER -