{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:24:32Z","timestamp":1763641472348},"reference-count":31,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,9,1]]},"abstract":"<jats:p>Post\u2013kala-azar dermal leishmaniasis (PKDL) is a complication of visceral leishmaniasis. Bangladesh national treatment guidelines during the study period called for 120 intramuscular injections of sodium antimony gluconate (SAG). We assessed care-seeking behavior, diagnosis and treatment costs, and coping strategies among 134 PKDL patients; 56 (42%) patients had been treated with SAG, and 78 (58%) remained untreated. The median direct cost per patient treated was US$367 (interquartile range [IQR] = 90\u2013284), more than two times the estimated per capita annual income for the study population. The most common coping strategy was to take a loan; the median amount borrowed was US$98 (IQR = 71\u2013150), with a median interest of US$32 (IQR = 16\u201395). Households lost a median of 123 work-days per patient treated. The current regimen for PKDL imposes a significant financial burden, reinforcing the link between poverty and visceral leishmaniasis. More practical shorter-course regimens for PKDL are urgently needed to achieve national and regional visceral leishmaniasis elimination goals.<\/jats:p>","DOI":"10.4269\/ajtmh.2011.10-0683","type":"journal-article","created":{"date-parts":[[2011,9,6]],"date-time":"2011-09-06T18:47:57Z","timestamp":1315334877000},"page":"528-534","source":"Crossref","is-referenced-by-count":17,"title":["Economic Consequences of Post\u2013Kala-Azar Dermal Leishmaniasis in a Rural Bangladeshi Community"],"prefix":"10.4269","volume":"85","author":[{"given":"Masayo","family":"Ozaki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shamim","family":"Islam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazi Mizanur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anisur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Luby","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caryn","family":"Bern","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Tropical Infectious Diseases: Principles, Pathogens and Practice","first-page":"1095","author":"Jeronimo","year":"2006"},{"year":"2009","series-title":"Kala-azar","author":"World Health Organization Regional Office for South-East Asia","key":"R2"},{"year":"2008","series-title":"The Global Burden of Disease","author":"World Health Organization","key":"R3"},{"key":"R4","series-title":"Lancet","first-page":"750","article-title":"Post-kala-azar dermal leishmaniasis in the absence of active visceral leishmaniasis","volume":"336","author":"el-Hassan","year":"1990"},{"key":"R5","series-title":"Clin Infect Dis","first-page":"73","article-title":"Increasing incidence of post-kala-azar dermal leishmaniasis in a population-based study in Bangladesh","volume":"50","author":"Rahman","year":"2010"},{"key":"R6","series-title":"Lancet Infect Dis","first-page":"87","article-title":"Post-kala-azar dermal leishmaniasis","volume":"3","author":"Zijlstra","year":"2003"},{"key":"R7","series-title":"Indian J Med Res","first-page":"144","article-title":"Efficacy of prolonged therapy with stibogluconate in post kala-azar dermal leishmaniasis","volume":"91","author":"Thakur","year":"1990"},{"key":"R8","series-title":"Expert Opin Emerg Drugs","first-page":"395","article-title":"Developments in the treatment of visceral leishmaniasis","volume":"14","author":"den Boer","year":"2009"},{"key":"R9","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":"R10","series-title":"Indian J Med Res","first-page":"275","article-title":"The epidemiology of visceral leishmaniasis in Bangladesh: prospects for improved control","volume":"123","author":"Bern","year":"2006"},{"year":"2009","series-title":"World Economic Outlook Database, October 2009","author":"International Monetary Fund","key":"R11"},{"key":"R12","series-title":"Indian J Med Res","first-page":"239","article-title":"Note on dermal leishmanoid","volume":"16","author":"Shortt","year":"1928"},{"key":"R13","series-title":"Bull World Health Organ","first-page":"341","article-title":"Ten years of kala-azar in West Bengal, Part I. Did post-kala-azar dermal leishmaniasis initiate the outbreak in 24-parganas?","volume":"70","author":"Addy","year":"1992"},{"key":"R14","series-title":"J Indian Med Assoc","first-page":"1","article-title":"Recurrence of kala-azar associated with post-kala-azar dermal leishmaniasis","volume":"50","author":"Sen Gupta","year":"1968"},{"key":"R15","series-title":"Acta Trop","first-page":"1","article-title":"The economic burden of kala-azar in households of the Danusha and Mahottari districts of Nepal","volume":"88","author":"Adhikari","year":"2003"},{"key":"R16","series-title":"Health Policy Plan","first-page":"129","article-title":"Paying for hospital-based care of kala-azar in Nepal: assessing catastrophic, impoverishment and economic consequences","volume":"24","author":"Adhikari","year":"2009"},{"key":"R17","series-title":"Am J Trop Med Hyg","first-page":"624","article-title":"Visceral leishmaniasis: consequences of a neglected disease in a Bangladeshi community","volume":"69","author":"Ahluwalia","year":"2003"},{"key":"R18","series-title":"Trends Parasitol","first-page":"552","article-title":"Leishmaniasis and poverty","volume":"22","author":"Alvar","year":"2006"},{"key":"R19","series-title":"Trop Med Int Health","first-page":"639","article-title":"The poorest of the poor: a poverty appraisal of households affected by visceral leishmaniasis in Bihar, India","volume":"14","author":"Boelaert","year":"2009"},{"key":"R20","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":"R21","series-title":"Trans R Soc Trop Med Hyg","first-page":"838","article-title":"The economic burden of visceral leishmaniasis for households in Nepal","volume":"100","author":"Rijal","year":"2006"},{"key":"R22","series-title":"Trans R Soc Trop Med Hyg","first-page":"156","article-title":"Socio-economics of 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