Visceral Leishmaniasis: Consequences of a Neglected Disease in a Bangladeshi Community

Abstract

Abstract. Visceral leishmaniasis, or kala azar (KA), affects the rural poor, causing significant morbidity and mortality. We examined the epidemiologic, social, and economic impact of KA in a village in Bangladesh. A populationbased survey among 2,348 people demonstrated a KA incidence of 2% per year from 2000 to 2002, with a case-fatality rate of 19% among adult women, compared with 6−8% among other demographic groups. Kala azar cases were geographically clustered in certain sections of the village. Anti-leishmanial drug shortages and the high cost of diagnosis and treatment caused substantial emotional and economic hardship for affected families. Communities wanted to learn more about KA, and were willing to take collective action to confront the problems it causes. To decrease the KA burden in endemic areas, community efforts should be supplemented with effective treatment programs to ensure access to appropriate and affordable diagnosis and case management.

Seasonal relationship between normalized difference vegetation index and abundance of the Phlebotomus kala-azar vector in an endemic focus in Bihar, India

“…The preservation of moisture due to remaining water-bodies within the study area is an alternative explanation. Also socio-economic variables, such as the degree of access to medical treatment and other factors that strongly influence the disease prevalence has been reported to influenced the outcome (Ahluwalia et al, 2003;Sharma et al, 2004;Kesari et al, 2010). Combining the NDVI map with that of the spatial distribution of kala-azar in the pre-monsoon and the post-monsoon seasons demonstrates that areas with NDVI values ≥0.20 generally coincide with areas with many reported kala-azar cases, which corroborates previous results (Elnaiem et al, 2003).…”

Economic Consequences of Post–Kala-Azar Dermal Leishmaniasis in a Rural Bangladeshi Community

“…9,[15][16][17][18][19][20][21][22] In South Asia, endemic foci are concentrated in rural areas and poorer states, and highly affected communities seem to be poorer than other communities in the same district. 16,19 Superimposed on this background, the disease itself further impoverishes affected families.…”

The Economic Value of a Visceral Leishmaniasis Vaccine in Bihar State, India

“…Death could have resulted from treated or untreated VL, standard amphotericin B treatment, or unrelated causes (age-specific crude mortality rate). [2][3][4][21][22][23] Those traveling through the "Susceptible and Well" state had the probability of developing VL or remaining uninfected ( Figure 1B). Cases could either be symptomatic or asymptomatic.…”

“…[1][2][3][4] Over 90% of the world's cases occur in five countries, India, Nepal, Bangladesh, Sudan, and Brazil, with at least half arising in India, of which the eastern rural state of Bihar (90% of all Indian cases) is particularly afflicted. 5,6 India and its neighboring countries of Nepal and Bangladesh are committed to fighting VL, and in collaboration with the Special Program for Research and Training in Tropical Diseases (TDR) initiative supported by the World Health Organization (WHO) have signed a memorandum of understanding with the ultimate goal of achieving VL elimination by 2015.…”