Table 2. Outcomes of included studies.

Leishmaniasis Subtype	Author	Measure	Outcome
Visceral Leishmaniasis	Alemayehu et al., 2017	WHOQOL-BREF	• HIV-VL patients had lower mean scores in all domains of questionnaire compared to HIV alone patients; • Depression strongly associated with all the QoL domains in HIV-VL patients; • The mean (SD) depressive-symptoms scale scores were higher 2.67 (±0.7) for HIV-VL patients compared to HIV patients 1.61 (±0.5) (p = 0.001).
	Alemayehu et al., 2018	WHOQOL-BREF	• Both groups improved in all the QoL domains was observed 6 months post-treatment with both antiretroviral treatment (ART) and anti-leishmanial drugs; • Mean scores for social relationship among co-infected patients were significantly lower compared to the HIV group (p = 0.001).
	Govil et al., 2018	KAP structured questionnaire	• 4.7% agreed that incidence of VL in the family should not be disclosed; • 43% reported that the illness affects mental health by causing stress, irritation or depression/fear of death; • ≃74% thought that VL in the family has financial consequences, causes impoverishment
Cutaneous Leishmaniasis	Bennis et al., 2018	n/a	• Quantitative and qualitative research indicated that localised CL is a source of psychological suffering, stigmatization, and lower QoL.
	Chahed et al., 2016	IPQ-R, WHOQOL-26, PSLI	• Emotional representations in CL correlated with loss of self-esteem, feelings of inferiority (r = 0.77, p<0.05); • Higher knowledge about CL correlated with lower the prospects of recovery (r = -0.30, p = 0.048); • Patients with more coherent perception of CL had stronger emotional reactions (r = 0.48, p<0.001); • Moderate correlations between total number of body scars and experiences of rejection (r = 0.31, p<0.05); • Experiences of rejection and avoidance of stress correlated negatively with age (r = -0.33, p<0.05; r = -0.31,p<0.05) • WHOQOL-26 and PSLI questionnaire results showed that the domains of Social QoL and anticipation avoidance of stress, and social QoL and total stress correlated significantly (r = -0.36, p<0.05 and r = -0.32, p<0.05).
	de Castro Toledo et al., 2013	DLQI	• In 70% of patients CL had a moderate to large effect on QoL in the “work and school” domain, followed by the “symptoms and feelings” domain. • The domain with the least impact was “personal relationships”;
	Handjani and Kalafi 2013	FDLQI	• No statistically significant difference in QoL of families of vitiligo, psoriasis, pemphigus and leishmaniasis patients.
	Honório et al., 2016	WHOQOL-BREF	• 90.9% had negative feelings (blue mood, anxiety, despair, depression); • Of these, 8 (18.18%) experienced these feelings always; 19 (43.18%) very often, 9 (20.45%) quite often, and 4 (9.09%) rarely. • 50% were dissatisfied with the support from family and friends, and in their intimate lives
	Layegh et al., 2017	CDLQI, CDI, STAIC	• Prevalence of low QoL, state anxiety, and trait anxiety was 57.1%, 76.9%, and 15.8% respectively; • 32% of patients had depression. • Cases of low QoL (54.1%), state anxiety (56.6%), and trait anxiety (53.8%) more common in acute form of leishmaniasis. • Low QoL (70.83%), state anxiety (76.66%), trait anxiety (83.3%), and depression (84.6%) were more prevalent in females; • Patients with facial lesions presented with low quality of life (63.3%), state anxiety (70.4%), trait anxiety (83.3%), and depression (54.5%). • No significant differences found for psychological factors when analysing gender, acute or chronic type of disease, presence of any other skin or systemic diseases, location of lesions, number of lesions, and duration of involvement (p > 0.05).
	Simsek et al. 2008	SCID-I	• 8 (53.3%) of the women who had CL had a mental health disorder; • CL was a significant predictor of any mental disorder (odds ratio 2.15, p< 0.05).
	Turan et al. 2015	CDI PedQL-C, PedQL-P, STAIC	• Scores for depression were higher in patients vs controls and QoL was lower in patients and their mothers; • All results were statistically significant (p<0.001 for CDI and p<0.05 for PedQL-P and PedQL-C). • No statistically significant results for scores using STAIC (p>0.05).
	Vares et al. 2013	DLQI	• Appearance and type of lesion significantly affected QoL (p<0.05); • Patients with ulcerated lesions had lower QoL vs nodular (p = 0.003) and plaque lesions (p = 0.005); • The activity of the disease, location of the lesions and gender did not affect the scores (p>0.05).
	Yanik et al. 2004	HAD, BIS and DQL	• Lesions on the face and hands, disease active for over a year, permanent scars and social stigmatisation led to anxiety and depression (p<0.01); • Body image satisfaction and QoL decreased significantly in CL patients with active lesions (p = 0.000); • Higher scores in patients with active CL; • Patients with active lesions had lower QoL mean scores compared to those with healed scars; • Correlations between the subscale of HAD and DQL showed a moderate correlation (anxiety r = 0.490, p< 0.001; depression r = 0.291, p = 0.040). • HAD and the BIS correlated significantly (anxiety r = 0.201, p = 0.047; depression r = 0.256, p = 0.011).
Post Kala-azar Dermal Leishmaniasis	Pal et al. 2008	DLQI, SF-36	• QoL significantly lower in patients <20 years (p = 0.03) and in those with more severe lesions (p = 0.001). • Initiation of treatment for PKDL improved scores (p = 0.04), • Gender, duration and location of the lesions had no impact on scores (p>0.05). • SF-36 showed that mental health, social functioning, body pain and general health were more severely affected in the patients compared to the control group (p<0.05).