Abstract
Kala-azar, a worldwide disease, is caused by the parasitic protozoan species of genus Leishmania and transmitted by species of sandflies. Awareness of the population about the disease is essential to run a successful control-strategies program. This cross-sectional study was conducted to assess the awareness of residents about it and related practices in two highly-endemic areas of Bangladesh. In total, 511 household respondents were selected conveniently from two unions (Kushmail and Kanihari) under two sub-districts (Trishal and Fulbaria) of Mymensingh district. Interviewer-administered questionnaires were used for assessing the awareness of the respondents about kala-azar and their practices. Knowledge scores were categorized as poor (<mean -1SD), average (mean ±1SD), good (>mean +1SD). Statistical tests were considered significant at p value of ≤5% (≤0.05). Chi-squared and Student's t-tests were performed for statistical analysis. The mean knowledge score of the respondents of Kanihari union regarding kala-azar was significantly higher than that of the respondents of Kushmail union (mean ±SD, 4.30 ±0.86 versus 4.12 ±0.75, p = 0.002). Of the respondents, 11% and 20% had good (>5.04), 77% and 72% had average (3.43-5.04), 12% and 8% had poor (<3.43) (GAP) knowledge on kala-azar in Kushmail union and Kanihari union respectively. However, the mean knowledge score of the respondents of Kanihari union relating sandfly was significantly lower compared to that of the respondents of Kushmail union (mean ±SD, 2.49 ±0.79 versus 2.65 ±0.85, p = 0.03). Of them, 22% and 19% had good (>3.39), 67% and 64% had average (3.39-1.75), and 11% and 17% had poor (<1.75) knowledge on sandfly in Kushmail union and Kanihari union respectively. More than 70% of the respondents from Kushmail and Kanihari mentioned only injection as the preferred treatment of kala-azar. Eighty-seven percent and 88% of the respondents in the two unions had chosen upazilla health complex for the treatment of their kala-azar. About 50% of the respondents in Kushmail and Kanihari liked to use coil or mat as a preventive measure to avoid sandfly bites. The findings of this study indicate the importance of awareness and related practices of the community people in two endemic areas that will help implement the kala-azar-elimination program successfully in Bangladesh.
Highlights
The World Health Organization (WHO) reported that more than 147 million people in the South-East Asia (SEA) region are at risk of contracting the Leishmania parasites that cause kala-azar, a life-threatening disease [1]
Each year an estimated 200,000–400,000 new cases of Visceral leishmaniasis (VL) have been reported worldwide, and >90% of the new cases of VL occurred in Bangladesh, Brazil, Ethiopia, India, Sudan, and South Sudan. 2.4 million disability-adjusted life-years (DALYs) are lost each year due to kala-azar, and the South-East Asia region accounts for the loss of about 400,000 DALYs
A study in rural Fulbaria during 2015–2016 found that 100% of respondents heard about kala-azar, only 0.93% were aware of sandfly [13]
Summary
The World Health Organization (WHO) reported that more than 147 million people in the South-East Asia (SEA) region are at risk of contracting the Leishmania parasites that cause kala-azar, a life-threatening disease [1]. It is spread by the bite of ‘female’-infected phlebotomine ‘sandfly’. Bangladesh, India, and Nepal have the largest burden of the disease in the region, and random cases have recently been reported from Bhutan and Thailand [1]. Each year an estimated 200,000–400,000 new cases of Visceral leishmaniasis (VL) have been reported worldwide, and >90% of the new cases of VL occurred in Bangladesh, Brazil, Ethiopia, India, Sudan, and South Sudan. Kala-azar is the disease of poverty and mostly distresses the socially-downgraded and deprived communities of the rural population and is recognized as the neglected tropical disease (NTD) [3]
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