Acceptance and potential barriers to effective use of diagnostic tests for visceral leishmaniasis in an urban area in Brazil

Assis, Tália Machado de; Guimarães, Paloma Nogueira; Oliveira, Edmundo Clarindo; Peruhype-Magalhães, Vanessa; Gomes, Luciana I.; Rabello, Ana

doi:10.1590/0037-8682-0247-2015

Cited by 2 publications

(3 citation statements)

References 5 publications

(4 reference statements)

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“…In an endemic area in Brazil, the direct cost of IT-LEISH® was estimated to be USD 6.62 compared to USD 6.72 for the Kala-Azar Detect® rapid test [169]. The IT LEISH was found to be more appropriate to implement in the same endemic area due to its use of capillary blood, the positive reaction of 96% of patients to the finger prick blood collection, and its acceptability among healthcare professionals [170]. The sensitivity of an in-house latex agglutination test based on A2 antigen (A2LAT) or promastigote lysates proteins (proLAT) were 88.4% (both tests), and specificity was 93.5% for A2LAT and 100% for proLAT [171].…”

Section: Resultsmentioning

confidence: 99%

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

et al. 2018

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BackgroundHealth personnel face challenges in diagnosing vector-borne and other diseases of poverty in urban settings. There is a need to know what rapid diagnostic technologies are available, have been properly assessed, and are being implemented to improve control of these diseases in the urban context. This paper characterizes evidence on the field validation and implementation in urban areas of rapid diagnostics for vector-borne diseases and other diseases of poverty.Main bodyA scoping review was conducted. Peer-reviewed and grey literature were searched using terms describing the targeted infectious diseases, diagnostics evaluations, rapid tests, and urban setting. The review was limited to studies published between 2000 and 2016 in English, Spanish, French, and Portuguese. Inclusion and exclusion criteria were refined post hoc to identify relevant literature regardless of study design and geography.A total of 179 documents of the 7806 initially screened were included in the analysis. Malaria (n = 100) and tuberculosis (n = 47) accounted for the majority of studies that reported diagnostics performance, impact, and implementation outcomes. Fewer studies, assessing mainly performance, were identified for visceral leishmaniasis (n = 9), filariasis and leptospirosis (each n = 5), enteric fever and schistosomiasis (each n = 3), dengue and leprosy (each n = 2), and Chagas disease, human African trypanosomiasis, and cholera (each n = 1). Reported sensitivity of rapid tests was variable depending on several factors. Overall, specificities were high (> 80%), except for schistosomiasis and cholera. Impact and implementation outcomes, mainly acceptability and cost, followed by adoption, feasibility, and sustainability of rapid tests are being evaluated in the field. Challenges to implementing rapid tests range from cultural to technical and administrative issues.ConclusionsRapid diagnostic tests for vector-borne and other diseases of poverty are being used in the urban context with demonstrated impact on case detection. However, most evidence comes from malaria rapid diagnostics, with variable results. While rapid tests for tuberculosis and visceral leishmaniasis require further implementation studies, more evidence on performance of current tests or development of new alternatives is needed for dengue, Chagas disease, filariasis, leptospirosis, enteric fever, human African trypanosomiasis, schistosomiasis and cholera.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0474-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

et al. 2018

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“…Using a participative strategy to structure assistance policies in primary health centers may favor rapid and decentralized diagnosis, by ensuring the adherence and efficiency of staff members, as well as their training. Such action can reduce leishmaniasis morbidity in Brazil 22 and economic impact 3,23 .…”

Section: Discussionmentioning

confidence: 99%

“…Yet, a study showed impasses in implementing fast diagnostic tests for visceral leishmaniasis in health services of an endemic municipality: health professionals refused to perform the rapid test during trainings; rapid tests presented problems in purchase and delay in the delivery; both patients and health professionals reported problems in collecting capillary blood; professionals in health care centers were unclear about their duties and responsibilities; and patients evaded to bigger cities 22 .…”

Section: Discussionmentioning

confidence: 99%

Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

et al. 2020

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Cutaneous leishmaniasis (CL) is a disease associated with low-income populations. Thus, in assessing the burden of this disease, it is important to include its economic impact on individuals. We aimed to evaluate CL economic impact on patients treated at a referral service in the State of Minas Gerais, Brazil. This is a cross-sectional study based on the analysis of interviews and medical records from which we assembled direct medical and non-medical costs related to CL, from a societal perspective. One hundred patients were included; 50% had a monthly per capita income of up to USD 259.60 and spent on average USD 187.32 with the disease, representing an average monthly impact of 22.5% (USD 133.80). The disease imposed direct medical costs, such as: private medical appointments, medications, medical exams, dressing material, and co-participation in health insurances. Direct non-medical costs were mainly related to patients’ transportation to health centers (USD 4,911.00), but also included medically-necessary care, food, and domestic and business outsourcing services. Although the Brazilian public health system guarantees access to health care, CL still represents a substantial economic impact for patients. The main action to reduce the expenses with this disease is decentralizing services for CL diagnosis and therapeutic approach, as well as increasing their efficiency.

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Acceptance and potential barriers to effective use of diagnostic tests for visceral leishmaniasis in an urban area in Brazil

Cited by 2 publications

References 5 publications

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

A scoping review on the field validation and implementation of rapid diagnostic tests for vector-borne and other infectious diseases of poverty in urban areas

Economic impact of localized cutaneous leishmaniasis on adult patients of a referral service in Belo Horizonte, Minas Gerais State, Brazil

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