{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:53:22Z","timestamp":1790009602921,"version":"4.0.1"},"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T00:00:00Z","timestamp":1629158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>In the Indian state of Bihar, visceral leishmaniasis (VL) is a major public health issue that has been aggravated by the rising incidence of new Human immunodeficiency virus (HIV) infections. In endemic areas, the risk of VL infections in patients living with HIV (PLHIV) is higher. It is important to investigate the disease-related knowledge, attitude, and practices (KAP) of PLHIV in Bihar in order to monitor HIV\/VL co-infection. Adequate knowledge, a positive attitude, and good practices for VL control are essential to stamp out the disease. This study investigated the KAP towards VL in HIV patients attending antiretroviral therapy (ART) clinic at ICMR-RMRIMS, Patna.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A questionnaire based cross-sectional study was performed among 120 HIV patients aged \u226518 years, to evaluate their KAP regarding visceral leishmaniasis. For the KAP indicators, each correct answer received a score of 1, while unsure and incorrect responses received a score of 0. Descriptive statistics and logistic regression were used for the analysis. Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 27.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The study population had a male (68.30%) preponderance with a mean age of 37.03 years \u00b1 9.80 years of standard deviation. The majority (93.30%) of the study participants had previously heard about VL. Only 32.10% of those who had heard about VL knew that the disease was transmitted by the sandfly. Most (80.40%) of the study respondents were ignorant of the sandfly breeding grounds. The vast majority (75.90%) had no idea how to recognize sandflies and were unaware of their biting time, leishmaniasis transmission season, and preventive practices. Although PLHIV are vulnerable to VL, only 27.70% of them agreed that VL is a fatal disease if untreated, and 42.90% believed they wear not at risk of developing the disease. Regarding the control methods of sandflies, 28.60% of participants did not use any methods to avoid sandfly bites. The multivariable analysis revealed that occupation and family history were the two independent predictor variables of the knowledge index. Age and gender were significantly associated with attitude towards VL. Participants working as laborers had significantly lesser odds (AOR: 0.248, 95% CI: 0.073\u20130.844) to follow good preventive practices. There were significantly higher odds of having good practice among participants aged 18\u201340 years (AOR: 6.866, 95% CI: 1.694\u201327.834) and those residing in urban areas (AOR: 4.159, 95% CI: 1.317\u201313.139) than their peers. Overall, 27.7% of respondents were knowledgeable, 41.1% had a positive mindset, and 33.9% had strong VL preventive habits, according to the study.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The study determined a remarkable gap in the knowledge attitude and practices towards VL among PLHIV. This underscores the need of augmented health education initiatives for PLHIV in endemic areas for good VL awareness and preventive practices.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0256239","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T22:02:36Z","timestamp":1629237756000},"page":"e0256239","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Knowledge, attitude and practices towards visceral leishmaniasis among HIV patients: A cross-sectional study from Bihar, India"],"prefix":"10.1371","volume":"16","author":[{"given":"Devipriya","family":"J. 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[March 2020]. https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/leishmaniasis."},{"key":"pone.0256239.ref004","doi-asserted-by":"crossref","first-page":"k5224","DOI":"10.1136\/bmj.k5224","article-title":"Eliminating visceral leishmaniasis in South Asia: the road ahead","volume":"364","author":"S Rijal","year":"2019","journal-title":"BMJ"},{"key":"pone.0256239.ref005","unstructured":"Accelerated plan for kala-azar elimination (2017). https:\/\/www.who.int\/leishmaniasis\/resources\/Accelerated_plan_for_Kala-azar_Elimination_2017\/en\/"},{"key":"pone.0256239.ref006","doi-asserted-by":"crossref","first-page":"e3053","DOI":"10.1371\/journal.pntd.0003053","article-title":"Visceral leishmaniasis and HIV co-infection in Bihar, India: long-term effectiveness and treatment outcomes with liposomal amphotericin B (AmBisome)","volume":"8","author":"S Burza","year":"2014","journal-title":"PLoS Negl Trop 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Immunol"},{"key":"pone.0256239.ref013","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s12955-017-0636-6","article-title":"Health-related quality of life of HIV infected adults with and without Visceral Leishmaniasis in Northwest Ethiopia","volume":"15","author":"M Alemayehu","year":"2017","journal-title":"Heal Qual Life Outcomes"},{"key":"pone.0256239.ref014","doi-asserted-by":"crossref","first-page":"e0008254","DOI":"10.1371\/journal.pntd.0008254","article-title":"Kala-azar elimination in a highly-endemic district of Bihar, India: A success story","volume":"14","author":"V Kumar","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pone.0256239.ref015","first-page":"1","article-title":"Awareness about kala-azar disease and related preventive attitudes and practices in a highly endemic rural area of India","volume":"41","author":"NA Siddiqui","year":"2010","journal-title":"Southeast Asian J Trop Med Public 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Govil","year":"2018","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0256239.ref019","doi-asserted-by":"crossref","first-page":"e0203407","DOI":"10.1371\/journal.pone.0203407","article-title":"Knowledge, stigma, health seeking behaviour and its determinants among patients with post kalaazar dermal leishmaniasis, Bihar, India","volume":"13","author":"P Garapati","year":"2018","journal-title":"PLoS One"},{"key":"pone.0256239.ref020","doi-asserted-by":"crossref","first-page":"505","DOI":"10.4269\/ajtmh.2006.75.505","article-title":"Knowledge, attitude, and practices related to Kala-azar in a rural area of Bihar state, India","volume":"75","author":"SP Singh","year":"2006","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0256239.ref021","doi-asserted-by":"crossref","first-page":"e0130929","DOI":"10.1371\/journal.pone.0130929","article-title":"A Cross-Sectional Survey of Knowledge, Attitude and Practices Related to Cutaneous Leishmaniasis and Sand Flies in Punjab, 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Health"},{"key":"pone.0256239.ref025","doi-asserted-by":"crossref","first-page":"566","DOI":"10.12980\/APJTB.4.2014C744","article-title":"Knowledge, attitude, and practices related to cutaneous leishmaniasis in an endemic focus of cutaneous leishmaniasis, Southern Iran","volume":"4","author":"B Sarkari","year":"2014","journal-title":"Asian Pac J Trop Biomed"},{"key":"pone.0256239.ref026","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.apjtb.2016.01.018","article-title":"Community knowledge, attitude and practice towards cutaneous leishmaniasis endemic area ochello, gamogofa zone, south Ethiopia","volume":"6","author":"N Kebede","year":"2016","journal-title":"Asian Pac J Trop Biomed"},{"key":"pone.0256239.ref027","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-021-05965-4","article-title":"Knowledge and attitude towards cutaneous leishmaniasis among rural endemic communities in Shara\u2019b district, Taiz, southwestern Yemen","volume":"21","author":"TH Alharazi","year":"2021","journal-title":"BMC Infect Dis"},{"key":"pone.0256239.ref028","volume":"8","author":"N L\u00f3pez-Perea","year":"2014","journal-title":"Knowledge, Attitudes and Practices Related to Visceral Leishmaniasis in Rural Communities of Amhara State: A Longitudinal Study in Northwest Ethiopia"},{"key":"pone.0256239.ref029","doi-asserted-by":"crossref","first-page":"e03152","DOI":"10.1016\/j.heliyon.2019.e03152","article-title":"Heliyon Knowledge, attitude and practices of the resident community about visceral leishmaniasis in West Armachiho district, Northwest Ethiopia","volume":"6","author":"H Tamrat","year":"2020","journal-title":"Heliyon"}],"container-title":["PLOS 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