Nav: Home

Reducing delays in identifying visceral leishmaniasis

June 27, 2019

Women in Indian states with endemic visceral leishmaniasis - also known as Kala Azar - should be encouraged to seek care for persistent fever without delay. Raised awareness about the disease and its symptoms, and the prioritization of women's care-seeking over household work could help reduce fatalities and potentially reduce overall transmission, according to research by independent consultant Beulah Jayakumar and colleagues, published in PLOS Neglected Tropical Diseases.

Visceral leishmaniasis is transmitted by sand flies. It is endemic in the Indian subcontinent and since 2005 there have been efforts to eliminate it as a public health problem. Though largely effective, these efforts have not yet achieved the threshold target in India, with four endemic states continuing to harbor disease. Detecting and treating the disease quickly is key, as this interrupts and shortens transmission from human hosts and improves patient outcomes - the only known hosts in the Indian subcontinent.

Beulah Jayakumar and colleagues interviewed 33 female patients from two states, Bihar and Jharkhand, along with 11 unqualified health providers and 12 groups of community elders. Women seem to access care later than men, partly due to the accepted prioritization of household work over what were considered mild and vague symptoms not considered serious enough to seek appropriate care and spend money on associated expenses. Additional causes for delayed treatment include securing a male chaperone for hospital visits and the perception that private facilities provide higher quality care.

Study limitations include the small sample size and lack of comparative analysis with male patients; additionally, patients were found from a national visceral leishmaniasis surveillance register, excluding patients who were not reported or recorded due to private care.

The authors conclude that there is a need for clearer messaging to increase awareness in the general population and among informal and formal care providers, and an emphasis on the need for early care seeking for women with persistent fever. They also identify missed opportunities in government care facilities, where diagnoses were missed either due to lack of testing or diagnostic tests administered too early.
In your coverage please use this URL to provide access to the freely available paper:

Citation: Jayakumar B, Murthy N, Misra K, Burza S (2019) "It's just a fever": Gender based barriers to care-seeking for visceral leishmaniasis in highly endemic districts of India: A qualitative study. PLOS Neglected Tropical Diseases 13(6): e0007457.

Funding: This research was conducted through financial support from UK Aid through the KalaCORE programme, grant PO 6361 ( The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing Interests: The authors have declared that no competing interests exist.


Related Disease Articles:

Findings support role of vascular disease in development of Alzheimer's disease
Among adults who entered a study more than 25 years ago, an increasing number of midlife vascular risk factors, such as obesity, high blood pressure, diabetes, high cholesterol and smoking, were associated with elevated levels of brain amyloid (protein fragments linked to Alzheimer's disease) later in life, according to a study published by JAMA.
Dietary factors associated with substantial proportion of deaths from heart disease, stroke, and disease
Nearly half of all deaths due to heart disease, stroke, and type 2 diabetes in the US in 2012 were associated with suboptimal consumption of certain dietary factors, according to a study appearing in the March 7 issue of JAMA.
Study links changes in oral microbiome with metabolic disease/risk for dental disease
A team of scientists from The Forsyth Institute and the Dasman Diabetes Institute in Kuwait have found that metabolic diseases, which are characterized by high blood pressure, high blood sugar, and obesity -- leads to changes in oral bacteria and puts people with the disease at a greater risk for poor oral health.
Fatty liver disease contributes to cardiovascular disease and vice versa
For the first time, researchers have shown that a bi-directional relationship exists between fatty liver disease and cardiovascular disease.
Seroprevalence and disease burden of chagas disease in south Texas
A paper published in PLOS Neglected Diseases led by researchers at the National School of Tropical Medicine at Baylor College of Medicine suggests that the disease burden in southern Texas is much higher than previously thought.
More Disease News and Disease Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Teaching For Better Humans
More than test scores or good grades — what do kids need to prepare them for the future? This hour, guest host Manoush Zomorodi and TED speakers explore how to help children grow into better humans, in and out of the classroom. Guests include educators Olympia Della Flora and Liz Kleinrock, psychologist Thomas Curran, and writer Jacqueline Woodson.
Now Playing: Science for the People

#534 Bacteria are Coming for Your OJ
What makes breakfast, breakfast? Well, according to every movie and TV show we've ever seen, a big glass of orange juice is basically required. But our morning grapefruit might be in danger. Why? Citrus greening, a bacteria carried by a bug, has infected 90% of the citrus groves in Florida. It's coming for your OJ. We'll talk with University of Maryland plant virologist Anne Simon about ways to stop the citrus killer, and with science writer and journalist Maryn McKenna about why throwing antibiotics at the problem is probably not the solution. Related links: A Review of the Citrus Greening...