Visceral Leishmaniasis: Consequences to Women in a Bangladeshi Community

Abstract

Visceral leishmaniasis (VL) or kala-azar (KA) affects the rural poor, causing significant morbidity and mortality. We examined the epidemiological and social impact of KA in an affected village in Bangladesh. A population-based survey of the village residents showed a case fatality rate of 14.7% among females and 5.3% among males. Before initiation of the study, female patients were ill longer than males before they received treatment. Future work needs to focus on understanding the implications of KA on women and to develop sustainable strategies for appropriate and timely access to treatment.

Social and Economic Burden of Human Leishmaniasis

“…In a study conducted in Bangladesh, most participants expressed anger and resentment toward the health-care system because of high cost of medication, fees paid to facilitate access to diagnosis and treatment, unnecessary medications, diagnostic tests and procedures, as well as lack of respect at hospitals. 48 Anthropological research with gender orientation will be valuable in showing how the consequences of infectious diseases may be different for men and women and may help in the development of gender-tailored preventive, coping, and intervention strategies. 16 Education, increase in the awareness of the disease, and control measures using health education materials that specifically target communities as well as increase in community participation have been identified by the World Health Organization as ways to enhance leishmaniasis control measures in marginalized endemic regions.…”

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.…”

“…As the maximum duration of active VL reported in the literature is 2 years, individuals could remain in the "VL" state for only one cycle before continuing on to either the "Death" or "Immune" states. [22][23][24] Those present in the "Immune" state as a result of vaccination were distinguished from those who had previous infection through a tracker variable. Therefore, only recovered cases that entered the "Immune" state had the probability of developing PKDL up to 2 years after VL infection.…”

“…43,44 The illness duration was the time between symptom onset and seeking treatment plus the length of inpatient treatment. 2,17,[22][23][24]37 To accommodate for variation in illness duration, a triangular distribution was created using values of 44, 150, and 570 days. [22][23][24] Data from the WHO provided regional, age-specific crude mortality rates and life expectancies.…”

“…2,17,[22][23][24]37 To accommodate for variation in illness duration, a triangular distribution was created using values of 44, 150, and 570 days. [22][23][24] Data from the WHO provided regional, age-specific crude mortality rates and life expectancies. 21 Disability was measured in DALYs and incorporated age-specific life expectancy and crude mortality rates for India as well as the disability weight assigned to VL by the WHO.…”