WHO South-East Asia Journal of Public Health
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Year : 2012  |  Volume : 1  |  Issue : 4  |  Page : 396-403

A study on delay in treatment of kala-azar patients in Bangladesh

1 Medicine Department, Dhaka Medical College Hospital, Dhaka, Bangladesh
2 Surya Kanta Kala Azar Research Centre, Mymensingh, Bangladesh
3 Medicine Department, Shahid Sarwardi Medical College Hospital, Dhaka, Bangladesh
4 Director General of Health Services; Dev Care Foundation, Dhaka, Bangladesh

Correspondence Address:
Ariful Basher
Surya Kanta Kala Azar Research Centre, Mymensingh
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DOI: 10.4103/2224-3151.207041

PMID: 28615604

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Visceral leishmaniasis (kala-azar) continues to be a major rural public health problem in Bangladesh. A cross-sectional study was carried out in two subdistricts of Mymensingh district from January 2006 to June 2007 to evaluate the delay kala-azar treatment. Suspected patients who attended to out patient department (OPD) were subjected to a dipstick test (RK39) for kala-azar. Sixty five from Bhaluka and 60 positive patients from Gafargaon subdistrict were enrolled. Most of the patients (80%) first visited nonqualified private practitioners, while only 15.2% consulted registered doctors. Fifty per cent were referred to the Upazilla health complex (UZHC) by the family members or relatives. About 49% and 43% patients required third and second health-care providers for kala-azar treatment, respectively. Patient delay ranged from 2 to 30 days; median 4 (IQR 3 to 7 days), the system delay ranged from 0 days to 225 days; median 54 (IQR 40–66 days). Residential status (p value <0.05) had impact on patient delay. Educational status and number of treatment providers had impact on system delay (p<0.05). System delay rather than patient delay is the important weakness of the kala-azar control programme in Bangladesh. Residence in rural areas, low educational background and treatment providers are associated with these delays. A proper educational programme may reduce the delay.

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