03173nas a2200325   4500000000100000008004100001260001200042653003300054653001100087653001900098653002900117653002200146653002500168653001800193100001400211700001200225700001400237700001100251700001400262700001700276700001200293700001300305700001600318245012000334856008800454300000700542490000600549520227800555022001402833       2022                            d  c09/202210aCultural dimension of health10aGender10aHealth beliefs10aHealth-seeking behaviour10aNeglected disease10aQualitative Research10aSocial Stigma1 aWenning B1 aPrice H1 aNuwangi H1 aReda K1 aWalters B1 aEhsanullah R1 aViana G1 aAndras A1 aDikomitis L00aExploring the cultural effects of gender on perceptions of cutaneous leishmaniasis: a systematic literature review.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511709/pdf/41256_2022_Article_266.pdf  a340 v73 a<p><strong>BACKGROUND: </strong>More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions.</p>

<p><strong>METHODS: </strong>We conducted a systematic review of the literature pertaining to either CL or muco-cutaneous leishmaniasis&nbsp;(MCL) through EBSCO, EMBASE, Medline, Scopus and Web of Science databases. To meet inclusion criteria, articles had to be either qualitative or mixed-method with a qualitative component. They also had to include a reflection on how the gender of participants impacted the findings and addressed the lived experiences of CL. We did not exclude articles based on the language they were published in or in which country the study took place.</p>

<p><strong>RESULTS: </strong>From a total of 1589 potential articles, we found that thirteen met the inclusion criteria. These articles were published in English, Spanish or Portuguese and reported on studies carried out in various countries in Africa, Asia and South America. After using the principles of a meta-ethnography to analyse these studies, we generated several key themes. We found that health-seeking behaviours, treatment choices, stigma and the impact of scarring are shaped by gender in a variety of contexts.</p>

<p><strong>CONCLUSIONS: </strong>Gender impacts on an individual's experience of CL. In particular, women are more constricted in their health-seeking behaviours and experience more stigma both from the active lesions and from scarring than men. In many contexts, however, men are more at risk of becoming infected by the parasite that causes CL and may turn to more harmful or aggressive self-treatments. We recommend that future research on CL should consider the impact of gender as this can create very different experiences for individuals.</p>
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