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

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.

1 Mar 2018
Academic paper
3.88 MB
zip

Presentations & Materials from KalaCORE Regional Technical Review Meeting: VL control programme overview

From November  29 – December 1 2017, KalaCORE hosted a Regional Technical Review Meeting and Workshop in Addis Ababa, Ethiopia, with representatives from the National Ministry of Health from all 3 KalaCORE-supported country programmes in Africa, DFID Ethiopia and DFID UK, KalaCORE implementing partners, WHO Geneva, WHO Sudan, WHO South Sudan and WHO Ethiopia, the KalaCORE Expert Steering Group, the NTD task force and the NGDO NTD task force.

The meeting succeeded in documenting lessons learned and improvement actions for current strategies across KalaCORE country contexts, prioritising activities for the remainder of the programme, sharing operational research findings for policy implementation, and initiating the pathway for developing the KalaCORE exit strategy and integration of key activities for sustainability.

    

18 Dec 2017
Publication
Improving surveillance, Health education, Case management
Ethiopia, Sudan, South Sudan
2.5 MB
zip

Presentations from KalaCORE Regional Technical Review Meeting: Ethiopia

18 Dec 2017
Publication
Health education, Case management, Improving surveillance, Training health workers
Ethiopia
1.87 MB
zip

Presentations from KalaCORE Regional Technical Review Meeting: South Sudan

18 Dec 2017
Publication
Health education, Case management, Improving surveillance, Training health workers
South Sudan
2.88 MB
zip

Presentations from KalaCORE Regional Technical Review Meeting: Sudan (FMoH)

18 Dec 2017
Publication
Health education, Training health workers, Improving surveillance, Case management
Sudan
2.79 MB
zip

Presentations from KalaCORE Regional Technical Review Meeting: Sudan (WHO)

18 Dec 2017
Publication
Health education, Case management, Improving surveillance, Training health workers
Sudan

The yin and yang of leishmaniasis control

Review looking at the current approaches and challenges in leishmaniasis control.  

7 Dec 2017
Academic paper

Pages