A Study on Health Seeking Behaviors of Patients of Post-Kala-Azar Dermal Leishmaniasis.

Ariful Basher,Shah Golam Nabi,Shahjada Selim,Be-Nazir Ahmed,Abul Faiz,Satya Ranjan Sutradhar,Md Fashiur Rahman,Matiur Rahman Bhuiyan,Proggananda Nath,Ridwanur Rahman

doi:10.1155/2015/314543

Abstract

Post-Kala-Azar Dermal Leishmaniasis (PKDL) remains a major public health threat in Bangladesh. A cross-sectional study was carried out in Surya Kanta Kala azar Research Centre (SKKRC), Mymensingh, from January 2012 to July 2013 to evaluate the health seeking behaviour and the length of delay of PKDL management. The consecutive 200 diagnosed PKDL cases that got treatment in SKKRC hospital were subjected to evaluation. Most (98%) of the patients were not aware and had no knowledge about PKDL, though 87.5% had a history of history of Kala-azar treatment. Many patients reported first to village doctor (15.5%), the pharmacy shop (10%), or traditional health provider (7.5%) upon recognition of symptom. The time between the initial symptom recognition and first medical consultation (patient delay) ranged from 10 days to 4745 days (13 years) with a median of 373 days (mean: 696; IQR: 138 to 900 days). The time between first medical consultations to definite treatment (system delay) ranged from 0 days to 1971 days (5.4 years), with a median delay of 14 days (mean: 46.48; IQR: 7 to 44 days) that was reported in this study. Age, education, occupation, and residential status had significant association with patient delay (P < 0.05). Educational status, occupation, number of treatment providers, and first health care provider had a significant association with system delay (P < 0.05). Success in PKDL diagnosis and treatment requires specific behavior from patients and health care providers which facilitate those practices.

Highlights

Bangladesh is one of the five countries bearing the major (90%) global burden of visceral leishmaniasis (VL), caused by parasite Leishmania donovani [1]
Post-Kala-Azar Dermal Leishmaniasis (PKDL), a curious phenomenon believed to be developed after treatment of Kala-Azar [3], presents with wide varieties of skin lesions ranging from hypopigmented marks, to erythematous papules, nodules, and others that appear in individuals
It is observed that the number of days of patient delay is much longer among PKDL patients in Bangladesh

Summary

Introduction

Bangladesh is one of the five countries bearing the major (90%) global burden of visceral leishmaniasis (VL), caused by parasite Leishmania donovani [1]. BioMed Research International and treatment increases the risk of transmissibility and morbidity [5, 6] This is true that sociocultural aspects of care or health seeking behavior particular to Bangladesh are unknown. Little is known about how individual and community health professionals perceive the disease of PKDL Such information is vital because successful control program requires a high level of understanding the pattern of health care seeking behavior. The study was designed to investigate PKDL patient care-seeking behavior and the causes of delay of treatment on affected household and identify the risk factors associated with long delay, if any in particular is related to choice of initial health care provider. Paucity of any evidence on the magnitudes of delay components (patient delay, health service delay, and total delay) and the factors associated with delay in care- seeking behavior among PKDL patients were among the reasons to conduct this study

Research Design and Methods

Result

Distribution of Delay

Findings

Discussion