Quality of life and patient satisfaction among individuals with cutaneous leishmaniasis in Syria: a cross-sectional study.

BACKGROUND: Cutaneous leishmaniasis (CL) is a neglected tropical disease with substantial physical, psychological, and social consequences, particularly in endemic, resource-limited settings. This study assessed the impact of CL on health-related quality of life (HRQoL) and patient satisfaction with care in an endemic region of Syria. METHODS: A cross-sectional study was conducted from May 1 to July 1, 2024 in Damascus University Hospital for Dermatology, Aleppo University Hospital, and two Ministry of Health CL treatment centers in Aleppo, Syria. HRQoL was measured using the dermatology life quality index (DLQI), and patient satisfaction using patient satisfaction questionnaire short form (PSQ-18). Sociodemographic and clinical characteristics were collected. Data were analyzed using SPSS (version 29). Medians and interquartile ranges (IQR) were used to describe non-normally distributed variables. Statistical tests included the Mann-Whitney U, Kruskal-Wallis, and Spearman's rank correlation. A P-value < 0.05 was considered significant. RESULTS: A total of 353 patients (55.9% female; median age 33 years) participated. The median DLQI score showed modest impairment, with the Symptoms and Feelings domain most affected (median 2, IQR 1-3; 87.5% scoring > 0). Female sex was significantly associated with higher Symptoms and Feelings (P = 0.018) and Personal Relationships (P = 0.020) scores. Head/neck lesions were significantly associated with worse Personal Relationships scores (P = 0.014). Satisfaction was generally high, with the highest median scores in Technical Quality (median 16, IQR 14-17) and Accessibility and Convenience (median 14, IQR 12-16). Urban residence was associated with higher General Satisfaction (P < 0.001), while number of treatment visits negatively correlated with Accessibility and Convenience (ρ = - 0.112, P = 0.035). CONCLUSIONS: CL in Syria imposes measurable psychosocial and functional burdens, particularly among women and those with visible lesions. Despite overall high satisfaction with care, disparities related to geography and treatment logistics persist. Addressing psychosocial needs and inequities in care accessibility may improve patient outcomes endemic settings.