title: Economic consequences of post-kala-azar dermal leishmaniasis in a rural Bangladeshi community.
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.
authors: Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors: Masayo
authors: M
authors: Ozaki
authors: Shamim
authors: S
authors: Islam
authors: Kazi Mizanur
authors: KM
authors: Rahman
authors: Anisur
authors: A
authors: Rahman
authors: Stephen P
authors: SP
authors: Luby
authors: Caryn
authors: C
authors: Bern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005191:Family Characteristics; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000191:economics* / Q000209:etiology*; D007898:Leishmaniasis, Visceral / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D055815:Young Adult