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

# metadata.dc.description.abstract[].value
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.

# metadata.dc.publisher[].value
The American Society of Tropical Medicine and Hygiene

# metadata.dc.relation.ispartof[].value
The American Journal of Tropical Medicine and Hygiene, 2018, vol. 98, num. 4, p. 1091 - 1101

# metadata.dc.rights[].value
cc by (c) American Society of Tropical Medicine and Hygiene, 2018

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
"Kala-Azar is a Dishonest Disease": Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudan