Students who completed an online course on cutaneous leishmaniasis feel they have gained more than simply learn about a disease that has now emerged as a major health hazard due to population displacements in the Eastern Mediterranean region1.
The Open University of Catalonia (UOC), together with the World Health Organization (WHO) is providing an interactive online training on the clinical management of cutaneous leishmaniasis since 2014. Sponsored applicants and WHO staff accessed the modules free of charge while other students used contents of a WHO publication entitled ‘Manual for case management of cutaneous leishmaniasis in the WHO Eastern Mediterranean Region’ as reference to complete their course.
Some students who completed the course commented in many ways:
“It was my first time using online tools and PDFs”.
“Problem-based learning proved very important to introduce concepts and ideas, particularly as participants had to prepare clinical cases for discussion with others.”
“Suddenly, I have become a referent among my colleagues. Most of them come to me with questions and doubts. I have gained lots of self-confidence in diagnosis and treatment, I feel more motivated and my patients are happier. I am in the same position, but my reputation has increased a lot among my peers.”
Others who enrolled over the first three years since 2014 say they are more motivated professionally, as they made the best of class management and were supportive and civil in their exchanges.
“Students have spoken of being engaged while completing assigned readings” said Dr Jose Antonio Ruiz Postigo, in charge of WHO’s Global Leishmaniasis control programme who launched the idea and contributed to writing the online course. “Involvement through discussion boards has been a crucial factor in online learning activities, not just for completing assignments but for helping one another achieve their goals.”
Data show a total of 76 out of 103 students from 16 countries in Africa and Asia successfully completed the modules over a period of four years.
The first three course editions mainly dealt with cutaneous leishmaniasis, but the last two editions starting 2017 included diseases such as leprosy, Buruli ulcer and yaws. Since 2017 the course has been offered to interested individuals or organizations outside MOH for a fee. These provide general information about skin diseases, differential diagnosis and monitoring and evaluation. The objective has been to disseminate a recently published WHO booklet2 as part of the proposed strategy to integrate approaches for the detection and control of neglected tropical diseases with skin manifestations.
Evaluation
The evaluation of the social impact was carried out through a qualitative methodology, interviewing seven students from different editions from different backgrounds. Impacts have been identified on a personal, professional and collective level.
At the personal level, students described a feeling of growth of personal motivation towards their mission and jobs.
On the professional side, students are consolidated as referees within their teams. For example, one of them was appointed supervisor of his team just after he had done the course, which makes it easier to implement the recommendations of clinical guides.
At the collective level, the course has proven to be a good source of social capital. Students are satisfied and currently, they continue to maintain contact with each other and with the teaching staff in order to obtain more information on topics related to various skin NTDs.
This sense of community and belonging can also reinforce the application of the concepts and methods learned during the course.
The disease
Leishmaniasis is caused by protozoan parasites from more than 20 Leishmania species and is transmitted to humans by the bite of infected female sandflies. There are three main forms of the disease: visceral, cutaneous and mucocutaneous.
Visceral leishmaniasis, the most serious form of the disease, is endemic in more than 80 countries. It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia. The disease is highly endemic in the Indian subcontinent and in East Africa. It is estimated that 90% of all new cases are reported from six countries: Brazil, Ethiopia, India, Somalia, South Sudan and Sudan.
Leishmaniasis owes its name to Sir William Leishman, a British army medical officer, who discovered the disease in 1901 and published his findings in 1903.
1Leishmaniasis manifests in three forms: cutaneous, visceral and mucocutaneous. Cutaneous leishmaniasis and visceral leishmaniasis, the most serious form of the disease, are transmitted by the bite of tiny sandflies. Before the war in Iraq and the Syrian Arab Republic, vector control and other measures protected the majority of people in this region.
2Recognizing neglected tropical diseases through changes on the skin. A training guide for front-line health workers