VISCERAL LEISHMANIASIS: CONSEQUENCES OF A NEGLECTED DISEASE IN A BANGLADESHI COMMUNITY

INDU B. AHLUWALIA Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by INDU B. AHLUWALIA in
Current site
Google Scholar
PubMed
Close
,
CARYN BERN Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by CARYN BERN in
Current site
Google Scholar
PubMed
Close
,
CRISTIANE COSTA Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by CRISTIANE COSTA in
Current site
Google Scholar
PubMed
Close
,
TANGIN AKTER Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by TANGIN AKTER in
Current site
Google Scholar
PubMed
Close
,
RAJIB CHOWDHURY Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by RAJIB CHOWDHURY in
Current site
Google Scholar
PubMed
Close
,
MUSTAKIM ALI Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by MUSTAKIM ALI in
Current site
Google Scholar
PubMed
Close
,
DIDARUL ALAM Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by DIDARUL ALAM in
Current site
Google Scholar
PubMed
Close
,
EBEN KENAH Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by EBEN KENAH in
Current site
Google Scholar
PubMed
Close
,
JOSEF AMANN Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by JOSEF AMANN in
Current site
Google Scholar
PubMed
Close
,
MEGHLA ISLAM Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by MEGHLA ISLAM in
Current site
Google Scholar
PubMed
Close
,
YUKIKO WAGATSUMA Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by YUKIKO WAGATSUMA in
Current site
Google Scholar
PubMed
Close
,
RASHIDUL HAQUE Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by RASHIDUL HAQUE in
Current site
Google Scholar
PubMed
Close
,
ROBERT F. BREIMAN Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by ROBERT F. BREIMAN in
Current site
Google Scholar
PubMed
Close
, and
JAMES H. MAGUIRE Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion and the Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Health Systems and Infectious Diseases Division and Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh

Search for other papers by JAMES H. MAGUIRE in
Current site
Google Scholar
PubMed
Close
Restricted access

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 population-based 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.

Author Notes

Reprint requests: Caryn Bern, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop F-22, Atlanta, GA 30341, E-mail: cxb9@cdc.gov.
  • 1

    Yamey G, Torreele E, 2002. The world’s most neglected diseases. BMJ 325: 176–177.

  • 2

    Seaman J, Mercer AJ, Sondorp E, 1996. The epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994. Int J Epidemiol 25 :862–871.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Bern C, Joshi AB, Jha SN, Das ML, Hightower A, Thakur GD, Bista MB, 2000. Factors associated with visceral leishmaniasis in Nepal: bed-net use is strongly protective. Am J Trop Med Hyg 63 :184–188.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Herwaldt BL, Berman JD, 1992. Recommendations for treating leishmaniasis with sodium stibogluconate (Pentostam) and review of pertinent clinical studies. Am J Trop Med Hyg 46 :296–306.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    el-Masum MA, Evans DA, Minter DM, el Harith A, 1995. Visceral leishmaniasis in Bangladesh: the value of DAT as a diagnostic tool. Trans R Soc Trop Med Hyg 89 :185–186.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Boelaert M, Criel B, Leeuwenburg J, van Damme W, Le Ray D, van der Stuyft P, 2000. Visceral leishmaniasis control: a public health perspective. Trans R Soc Trop Med Hyg 94 :465–471.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Desjeux P, 1996. Leishmaniasis. Public health aspects and control. Clin Dermatol 14 :417–423.

  • 8

    Murray CJL, Lopez AD, 1996. Global Health Statistics: A Compendium of Incidence, Prevalence, and Mortality Estimates for Over 200 Conditions. Murray CJL, Lopez AD, eds. Global Burden of Disease and Injury Series. Volume II. Boston: Harvard University Press.

    • PubMed
    • Export Citation
  • 9

    Directorate General for Health Services, 2001. National Kala Azar Surveillance Data. Dhaka, Bangladesh: Government of Bangladesh.

    • PubMed
    • Export Citation
  • 10

    Koirala S, Parija SC, Karki P, Das ML, 1998. Knowledge, attitudes, and practices about kala-azar and its sandfly vector in rural communities of Nepal. Bull World Health Organ 76 :485–490.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Badaro R, Jones TC, Lorenco R, Cerf BJ, Sampaio D, Carvalho EM, Rocha H, Teixeira R, Johnson WD Jr, 1986. A prospective study of visceral leishmaniasis in an endemic area of Brazil. J Infect Dis 154 :639–649.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Cerf BJ, Jones TC, Badaro R, Sampaio D, Teixeira R, Johnson WD Jr, 1987. Malnutrition as a risk factor for severe visceral leishmaniasis. J Infect Dis 156 :1030–1033.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Chappuis F, Rijal S, Singh R, Acharya P, Karki BM, Das ML, Bovier PA, Desjeux P, Le Ray D, Koirala S, Loutan L, 2003. Prospective evaluation and comparison of the direct agglutination test and an rK39-antigen-based dipstick test for the diagnosis of suspected kala-azar in Nepal. Trop Med Int Health 8 :277–285.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Bern C, Jha SN, Joshi AB, Thakur GD, Bista MB, 2000. Use of the recombinant K39 dipstick test and the direct agglutination test in a setting endemic for visceral leishmaniasis in Nepal. Am J Trop Med Hyg 63 :153–157.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Stewart D, Shamdasani PN, 1990. Focus Groups: Theory and Practice. Newbury Park, CA: Sage Publications.

    • PubMed
    • Export Citation
  • 16

    Carey JW, Wenzel P, Reilly C, Sheridan J, Steinberg J, 1997. CDC EZ-Text: Software for Collection, Management and Analysis of Semi-Structured Qualitative Databases. Atlanta: Conwal Incorporated for the Centers for Disease Control and Prevention.

    • PubMed
    • Export Citation
  • 17

    Miles MB, Huberman MA, 1994. Qualitative Data Analysis. Thousand Oaks, CA: Sage Publications.

    • PubMed
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 337 208 7
Full Text Views 391 14 1
PDF Downloads 77 9 0
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save