"Kala-Azar is a Dishonest Disease": Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudan

Hdl Handle:
http://hdl.handle.net/10144/619106
Title:
"Kala-Azar is a Dishonest Disease": Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudan
Authors:
Sunyoto, T; Adam, GK; Atia, AM; Hamid, Y; Babiker, RA; Abdelrahman, N; Vander Kelen, C; Ritmeijer, K; Alcoba, G; den Boer, M; Picado, A; Boelaert, M
Journal:
The American Journal of Tropical Medicine and Hygiene
Abstract:
Early diagnosis and treatment is the principal strategy to control visceral leishmaniasis (VL), or kala-azar in East Africa. As VL strikes remote rural, sparsely populated areas, kala-azar care might not be accessed optimally or timely. We conducted a qualitative study to explore access barriers in a longstanding kala-azar endemic area in southern Gadarif, Sudan. Former kala-azar patients or caretakers, community leaders, and health-care providers were purposively sampled and thematic data analysis was used. Our study participants revealed the multitude of difficulties faced when seeking care. The disease is well known in the area, yet misconceptions about causes and transmission persist. The care-seeking itineraries were not always straightforward: "shopping around" for treatments are common, partly linked to difficulties in diagnosing kala-azar. Kala-azar is perceived to be "hiding," requiring multiple tests and other diseases must be treated first. Negative perceptions on quality of care in the public hospitals prevail, with the unavailability of drugs or staff as the main concern. Delay to seek care remains predominantly linked to economic constraint: albeit treatment is for free, patients have to pay out of pocket for everything else, pushing families further into poverty. Despite increased efforts to tackle the disease over the years, access to quality kala-azar care in this rural Sudanese context remains problematic. The barriers explored in this study are a compelling reminder of the need to boost efforts to address these barriers.
Publisher:
American Society of Tropical Medicine and Hygiene
Issue Date:
13-Apr-2018
URI:
http://hdl.handle.net/10144/619106
DOI:
10.4269/ajtmh.17-0872
PubMed ID:
29488462
Additional Links:
http://www.ajtmh.org
Submitted date:
2018-04-23
Language:
en
ISSN:
1476-1645
Appears in Collections:
Leishmaniasis/Kala Azar

Full metadata record

DC FieldValue Language
dc.contributor.authorSunyoto, Ten
dc.contributor.authorAdam, GKen
dc.contributor.authorAtia, AMen
dc.contributor.authorHamid, Yen
dc.contributor.authorBabiker, RAen
dc.contributor.authorAbdelrahman, Nen
dc.contributor.authorVander Kelen, Cen
dc.contributor.authorRitmeijer, Ken
dc.contributor.authorAlcoba, Gen
dc.contributor.authorden Boer, Men
dc.contributor.authorPicado, Aen
dc.contributor.authorBoelaert, Men
dc.date.accessioned2018-04-27T13:23:34Z-
dc.date.available2018-04-27T13:23:34Z-
dc.date.issued2018-04-13-
dc.date.submitted2018-04-23-
dc.identifier.citation"Kala-Azar is a Dishonest Disease": Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudan. 2018, 98 (4):1091-1101 Am. J. Trop. Med. Hyg.en
dc.identifier.issn1476-1645-
dc.identifier.pmid29488462-
dc.identifier.doi10.4269/ajtmh.17-0872-
dc.identifier.urihttp://hdl.handle.net/10144/619106-
dc.description.abstractEarly diagnosis and treatment is the principal strategy to control visceral leishmaniasis (VL), or kala-azar in East Africa. As VL strikes remote rural, sparsely populated areas, kala-azar care might not be accessed optimally or timely. We conducted a qualitative study to explore access barriers in a longstanding kala-azar endemic area in southern Gadarif, Sudan. Former kala-azar patients or caretakers, community leaders, and health-care providers were purposively sampled and thematic data analysis was used. Our study participants revealed the multitude of difficulties faced when seeking care. The disease is well known in the area, yet misconceptions about causes and transmission persist. The care-seeking itineraries were not always straightforward: "shopping around" for treatments are common, partly linked to difficulties in diagnosing kala-azar. Kala-azar is perceived to be "hiding," requiring multiple tests and other diseases must be treated first. Negative perceptions on quality of care in the public hospitals prevail, with the unavailability of drugs or staff as the main concern. Delay to seek care remains predominantly linked to economic constraint: albeit treatment is for free, patients have to pay out of pocket for everything else, pushing families further into poverty. Despite increased efforts to tackle the disease over the years, access to quality kala-azar care in this rural Sudanese context remains problematic. The barriers explored in this study are a compelling reminder of the need to boost efforts to address these barriers.en
dc.language.isoenen
dc.publisherAmerican Society of Tropical Medicine and Hygieneen
dc.relation.urlhttp://www.ajtmh.orgen
dc.rightsArchived with thanks to The American Journal of Tropical Medicine and Hygieneen
dc.title"Kala-Azar is a Dishonest Disease": Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudanen
dc.identifier.journalThe American Journal of Tropical Medicine and Hygieneen

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