REASONS OF ABANDONMENT TREATMENT IN PATIENTS WITH LEISHMANIASIS

Öz

The goals of this study that examined patients with Cutaneous Leishmaniasis (CL) who were diagnosed and treated at the Sanliurfa Cutaneous Leishmaniasis Diagnosis and Treatment Center (SCLDTC), were to determine the frequency of treatment discontinuation and the reasons for discontinuation. This was a descriptive study that included individuals who visited the SCLDTC for diagnosis and treatment in 2020 and were diagnosed with CL. The study’s data collection phase took place between July 1, 2020 and December 31, 2020. The study comprised 370 patients who were diagnosed with CL and under treatment as of January 1, 2020. It was found that 187 of these patients discontinued treatment. The frequency of treatment discontinuation was 50.5%. Of those who discontinued treatment, 50.8% were women. It was determined that 3.7% of those who discontinued treatment did not speak Turkish, and 41.1% had not received formal education. Among the patients who discontinued treatment, 21.4% had no job, and 83.9% belonged to the lower socioeconomic status and unemployed group. Of those who discontinued treatment, 54.6% stopped before completing the first course, while 39,0% did not attend the follow-up examination after completing the first course. In cases of cutaneous leishmaniasis, the most common reasons for discontinuing treatment were believing that they do not require treatment (28.9%), disregarding the disease (27.3%), and a lack of medication in SCLDTC (26.7%). In the present study, the most common reasons for discontinuing treatment were a lack of belief in the necessity for treatment, disregarding the disease, and a shortage of medication. Patients’ and society’s knowledge and awareness of CL should be increased, public education programs should be organized, patients admitted to SCLDTC and their relatives should be informed, and the importance of completing the treatment should be explained, especially in neighborhoods where CL cases are densely distributed.

Anahtar Kelimeler

• Leishmaniasis
• treatment discontinuation
• neglected tropical diseases

ŞARK ÇIBANI VAKALARINDA TEDAVİ TERK DURUMU VE NEDENLERİ

Öz

Bu çalışmanın amacı, Şanlıurfa Şark Çıbanı Tanı ve Tedavi Merkezi’nde tanısı konan ve tedaviye başlanan Kutanöz Layşmanyazis (KL) hastalarının; tedaviyi terk etme sıklığını saptamak ve tedaviyi terk etme nedenlerini belirlemektir. Araştırma tanımlayıcı tiptedir. Çalışmanın evrenini, 2020 yılında Şanlıurfa Şark Çıbanı Tanı ve Tedavi Merkezi’ne (ŞÇTTM) tanı ve tedavi amacıyla başvurup, KL tedavisine başlanan hastalar oluşturdu. Veri toplama aşaması 1 Temmuz 2020 – 31 Aralık 2020 tarihleri arasında gerçekleştirildi. Çalışmaya 1 Ocak 2020 tarihi itibariyle KL tanısı almış ve tedavi görmekte olan 370 hasta dahil edildi. Hastaların 187'sinin tedaviyi terk ettiği saptandı. Tedaviyi bırakma sıklığı %50,5 idi. Tedaviyi bırakanların %50,8'ini kadınlar oluşturdu. Tedaviyi bırakanların %3,7'sinin Türkçe bilmediği, %41,1'inin örgün eğitim almadığı saptandı. Tedaviyi bırakan hastaların %21,4’ü herhangi bir işte çalışmamaktadır ve %83,9'u alt sosyal sınıf ve işsiz grubunu oluşturmaktadır. Tedaviyi bırakanların %54,6'sı ilk kürü tamamlamadan tedaviyi bırakırken, %39,0'ı ilk kürü tamamladıktan sonra kontrol muayenesine gelmemiştir. Şark çıbanı olgularında en sık tedaviyi bırakma nedenleri; tedaviye ihtiyacı olmadığını düşünme (%28,9), önemsememe (%27,3) ve ŞÇTTM'de ilaç bulunmaması (%26,7) idi. Diğer nedenler ise COVID-19 pandemisi nedeniyle temas etmek istememe (%10,2), mevsimlik tarım işçiliği nedeniyle şehir dışında olmak (%5,9) olarak sıralandı. Bu çalışmada en sık tedaviyi bırakma nedenleri tedaviye ihtiyacı olmadığını düşünme, hastalığı önemsememe ve ilaç yetersizliği idi. KL vakalarının yoğun olduğu mahallelerde hastaların ve toplumun KL konusundaki bilgi ve farkındalığı artırılmalı, halk eğitim programları düzenlenmeli, SÇTTM'ye başvuran hastalar ve yakınları bilgilendirilmeli, tedaviyi tamamlamanın önemi anlatılmalıdır.

Anahtar Kelimeler

• Şark çıbanı
• tedaviyi terk etme
• tedaviyi bırakma
• ihmal edilmiş tropikal hastalıklar

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