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