Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/122191
Title: "Kala-Azar is a Dishonest Disease": Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudan
Author: Sunyoto, Temmy
Adam, Gamal K.
Atia, Atia M.
Hamid, Yassin
Babiker, Rabie Ali
Abdelrahman, Nugdalla
Vander Kelen, Catiane
Ritmeijer, Koert
Alcoba, Gabriel
Boer, Margriet den
Picado, Albert
Boelaert, Marleen
Keywords: Leishmaniosi
Àfrica oriental
Leishmaniasis
East Africa
Issue Date: Apr-2018
Publisher: The American Society 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.
Note: Reproducció del document publicat a: http://dx.doi.org/10.4269/ajtmh.17-0872
It is part of: The American Journal of Tropical Medicine and Hygiene, 2018, vol. 98, num. 4, p. 1091 - 1101
URI: http://hdl.handle.net/2445/122191
Related resource: http://dx.doi.org/10.4269/ajtmh.17-0872
ISSN: 0002-9637
Appears in Collections:Articles publicats en revistes (ISGlobal)

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