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Am J Trop Med Hyg. 2011 Sep;85(3):528-34. doi: 10.4269/ajtmh.2011.10-0683.

Economic consequences of post-kala-azar dermal leishmaniasis in a rural Bangladeshi community.

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1
Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.

Abstract

Post-kala-azar dermal leishmaniasis (PKDL) is a complication of visceral leishmaniasis. Bangladesh national treatment guidelines during the study period called for 120 intramuscular injections of sodium antimony gluconate (SAG). We assessed care-seeking behavior, diagnosis and treatment costs, and coping strategies among 134 PKDL patients; 56 (42%) patients had been treated with SAG, and 78 (58%) remained untreated. The median direct cost per patient treated was US$367 (interquartile range [IQR] = 90-284), more than two times the estimated per capita annual income for the study population. The most common coping strategy was to take a loan; the median amount borrowed was US$98 (IQR = 71-150), with a median interest of US$32 (IQR = 16-95). Households lost a median of 123 work-days per patient treated. The current regimen for PKDL imposes a significant financial burden, reinforcing the link between poverty and visceral leishmaniasis. More practical shorter-course regimens for PKDL are urgently needed to achieve national and regional visceral leishmaniasis elimination goals.

PMID:
21896817
PMCID:
PMC3163879
DOI:
10.4269/ajtmh.2011.10-0683
[Indexed for MEDLINE]
Free PMC Article

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