Validation of an Afan Oromo translation of the Cutaneous Leishmaniasis Impact Questionnaire

Introduction Cutaneous leishmaniasis (CL) is a neglected tropical disease associated with reduced health-related quality of life (HRQoL) that leads to permanent scars, anatomical damage and functional impairment. We aimed to translate, culturally adapt and validate the disease specific HRQoL measure the Cutaneous Leishmaniasis Impact Questionnaire (CLIQ) into Afan Oromo. Methods The English version of the CLIQ was translated into Afan Oromo, and culturally adapted by experts with feedback from individuals affected by CL. The finalized Afan Oromo version was then administered to adults with CL. Its psychometric properties were examined using internal reliability, inter rater reliability, construct validity, and responsiveness to change. In addition, the clinical importance difference (CID) and cut-off points for the total CLIQ score were determined. Results The Afan Oromo CLIQ demonstrated acceptable content validity, with I-CVI values ranging 0.83 to1.00. One hundred and forty-four individuals with confirmed CL with a mean age of 35.5 ({+/-}16.5) years were interviewed using the Afan-Oromo version of the CLIQ. The overall median CLIQ score was 40 (IQR=24). The median score for general impacts of CL (Cluster-1), and perceptions about health services and treatment (Cluster-2) were 32 and 9 respectively. The internal consistency (Cronbach alpha= 0.87) and inter-rater reliability (ICC=0.98) were excellent. The differences in median CLIQ scores between physicians determined CL severity classifications and between small and larger lesions were significant. The Afan Oromo CLIQ was responsive to change following treatment (P = 0.037). The CID was 9 and 7 units, using distribution and anchor methods, respectively. Conclusion The Afan Oromo CLIQ is a valid and reliable disease-specific instrument to assess HRQoL of CL affected individuals.