How do health care providers deal with kala-azar in the Indian subcontinent?
Authors
Narendra Kumar
RMRIMS (ICMR), Patna, India
N Siddiqui
RMRIMS (ICMR), Patna, India
Siddhivinayak Hirve
KEM Hospital Research Center, Pune, India
Axel Kroeger
Special Programme for Research & Training in Tropical Diseases, TDR, World Health Organization, Geneva, Switzerland & Liverpool School of Tropical Medicine, Liverpool, UK
Shyam Sundar
Banaras Hindu University, Varanasi, India
Pradeep Das
RMRIMS (ICMR), Patna, India
Anand Joshi
Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
Dinesh Mondal
ICDDR,B, Dhaka, Bangladesh
Shri Singh
Banaras Hindu University, Varanasi, India
Marleen Boelaert
Institute of Tropical Medicine, Antwerp, Belgium
Keywords:
Bangladesh, control, elimination, India, Nepal, provider survey, visceral leishmaniasis
Abstract
Background & objectives:
Three countries, Bangladesh, India and Nepal, set out to eliminate kala-azar by 2015. This study was aimed to document the knowledge and practices in kala-azar case management of public and private health providers in these three countries.
Methods:
A health care provider survey was conducted in 2007 at 4 study sites, viz., Muzaffarpur and Vaishali districts in India, Mahottari district in Nepal, and Rajshahi district in Bangladesh. Interviews were conducted with formal and informal health care providers at their home or practice.
Results:
About half of the providers in India and Nepal knew the rapid diagnostic test rK39 recommended by the elimination initiative, but this was not in Bangladesh. Knowledge of the recommended first-line drug, miltefosine, was good in India and Nepal but less so in Bangladesh.
Interpretation & conclusions:
Innovative tools for VL care have not yet been fully taken up by private for profit care providers in the three countries that launched a VL elimination initiative. The elimination initiative needs to address these gaps in private providers’ knowledge, given their substantial share in the care of VL patients.
Keywords: Bangladesh, control, elimination, India, Nepal, provider survey, visceral leishmaniasis
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