{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T01:17:03Z","timestamp":1785028623065,"version":"3.55.0"},"reference-count":39,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,12,4]]},"abstract":"<jats:p>Visceral leishmaniasis (VL) is a neglected parasitic disease that is fatal if left untreated and is endemic in eastern Sudan. We estimated the direct and indirect costs of treatment of VL from the perspective of the provider and the household at three public hospitals in Gedaref State. The median total cost for one VL episode was estimated to be US$450. Despite the free provision of VL drugs at public hospitals, households bore 53% of the total cost of VL with one episode of VL representing 40% of the annual household income. More than 75% of households incurred catastrophic out-of-pocket expenditures. The length of treatment of 30 days led to important costs for both health providers and households. Alternative treatment regimens that reduce the duration of treatment are urgently needed.<\/jats:p>","DOI":"10.4269\/ajtmh.12-0585","type":"journal-article","created":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T04:13:38Z","timestamp":1383624818000},"page":"1146-1153","source":"Crossref","is-referenced-by-count":38,"title":["The Economic Burden of Visceral Leishmaniasis in Sudan: An Assessment of Provider and Household Costs"],"prefix":"10.4269","volume":"89","author":[{"given":"Filip","family":"Meheus","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abuzaid A.","family":"Abuzaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Baltussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brima M.","family":"Younis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manica","family":"Balasegaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eltahir A. G.","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen","family":"Boelaert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Musa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Lancet","first-page":"1561","article-title":"Advances in leishmaniasis","volume":"366","author":"Murray","year":"2005"},{"key":"R2","series-title":"Trop Med Int Health","first-page":"1715","article-title":"Costs of patient management of visceral leishmaniasis in Muzaffarpur, Bihar, India","volume":"11","author":"Meheus","year":"2006"},{"key":"R3","series-title":"Trop Med Int Health","first-page":"757","article-title":"The economic impact of visceral leishmaniasis on households in Bangladesh","volume":"11","author":"Sharma","year":"2006"},{"key":"R4","series-title":"PLoS Negl Trop Dis","first-page":"e2062","article-title":"The economic burden of visceral leishmaniasis on households in eastern Nepal","volume":"7","author":"Uranw","year":"2013"},{"key":"R5","series-title":"Fifth Population and Housing Census 2008","author":"Central Bureau of Statistics Sudan","year":"2011"},{"key":"R6","series-title":"Trop Med Int Health","first-page":"509","article-title":"Unseen Kala-azar deaths in south Sudan (1999\u20132002)","volume":"11","author":"Collin","year":"2006"},{"key":"R7","series-title":"Clin Dermatol","first-page":"417","article-title":"Leishmaniasis: public health aspects and control","volume":"14","author":"Desjeux","year":"1996"},{"key":"R8","series-title":"Health System Profile Sudan","author":"WHO","year":"2006"},{"key":"R9","series-title":"Leishmaniasis Control in Eastern Africa: Past and Present Efforts and Future Needs","author":"Malaria Consortium","year":"2010"},{"key":"R10","series-title":"Trop Med Int Health","first-page":"404","article-title":"Evaluation of a mass distribution programme for fine-mesh impregnated bed nets against visceral leishmaniasis in eastern Sudan","volume":"12","author":"Ritmeijer","year":"2007"},{"key":"R11","series-title":"Manual for diagnosis and treatment of leishmaniasis","author":"Federal Ministry of Health Sudan","year":"2004"},{"key":"R12","series-title":"Trans R Soc Trop Med Hyg","first-page":"350","article-title":"Treatment of visceral leishmaniasis in south-eastern Nepal: decreasing efficacy of sodium stibogluconate and need for a policy to limit further decline","volume":"97","author":"Rijal","year":"2003"},{"key":"R13","series-title":"Clin Infect Dis","first-page":"1104","article-title":"Failure of pentavalent antimony in visceral leishmaniasis in India: report from the center of the Indian epidemic","volume":"31","author":"Sundar","year":"2000"},{"key":"R14","series-title":"PLoS Negl Trop Dis","first-page":"e709","article-title":"Geographical variation in the response of visceral leishmaniasis to paromomycin in East Africa: a multicentre, open-label, randomized trial","volume":"4","author":"Hailu","year":"2010"},{"key":"R15","series-title":"Am J Trop Med Hyg","first-page":"89","article-title":"Treatment of kala-azar in southern Sudan using a 17-day regimen of sodium stibogluconate combined with paromomycin: a retrospective comparison with 30-day sodium stibogluconate monotherapy","volume":"77","author":"Melaku","year":"2007"},{"key":"R16","series-title":"PLoS Negl Trop Dis","first-page":"e1674","article-title":"Sodium stibogluconate (SSG) & paromomycin combination compared to SSG for visceral leishmaniasis in East Africa: a randomized controlled trial","volume":"6","author":"Musa","year":"2012"},{"key":"R17","series-title":"Trials","first-page":"166","article-title":"Safety and efficacy of miltefosine alone and in combination with sodium stibogluconate and liposomal amphotericin B for the treatment of primary visceral leishmaniasis in East Africa: study protocol for a randomized controlled trial","volume":"12","author":"Omollo","year":"2011"},{"key":"R18","series-title":"Trans R Soc Trop Med Hyg","first-page":"505","article-title":"Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis","volume":"86","author":"Zijlstra","year":"1992"},{"issue":"(Suppl 1)","key":"R19","series-title":"Trans R Soc Trop Med Hyg","first-page":"S27","article-title":"Leishmaniasis in Sudan. 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