Leishmaniasis and poverty.
ABSTRACT Leishmaniasis, a neglected tropical disease, has strong but complex links with poverty. The burden of leishmaniasis falls disproportionately on the poorest segments of the global population. Within endemic areas, increased infection risk is mediated through poor housing conditions and environmental sanitation, lack of personal protective measures and economically driven migration and employment that bring nonimmune hosts into contact with infected sand flies. Poverty is associated with poor nutrition and other infectious diseases, which increase the risk that a person (once infected) will progress to the clinically manifested disease. Lack of healthcare access causes delays in appropriate diagnosis and treatment and accentuates leishmaniasis morbidity and mortality, particularly in women. Leishmaniasis diagnosis and treatment are expensive and families must sell assets and take loans to pay for care, leading to further impoverishment and reinforcement of the vicious cycle of disease and poverty. Public investment in treatment and control would decrease the leishmaniasis disease burden and help to alleviate poverty.
ISOPS VIII International Symposium on Phlebotomine Sandflies, Puerto Iguazù, Argentina; 09/2014
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ABSTRACT: Visceral leishmaniasis, or kala-azar (KA), is a vector-borne disease caused by Leishmania species, protozoan parasites. KA is endemic in Bangladesh. Data suggest that more than 60% of KA cases reported worldwide during 2004-2008 occurred in Bangladesh, Nepal and India. In 2005, these three countries signed a memorandum of understanding with the aim of reducing the KA burden in each country to less than one case per 10,000 per year by 2015. In 2008, the Government of Bangladesh initiated a National KA Elimination Program (NKEP). This report provides an update on the program and identifies challenges to reducing the KA burden in Bangladesh. The program focuses on three elements: early case detection, effective treatment, and vector control. The number of KA cases identified in Bangladesh decreased from 6,892 to 1,902 during 2005-2012 and the number of sub-districts classified as hyper-endemic for KA decreased from seven in 2008 to three in 2012. NKEP has made substantial progress since its inception but has not yet met its goal.
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ABSTRACT: The current outbreak of Ebola virus disease (EVD) in West Africa and the subsequent spread to other countries demonstrates the risk of extension to unaffected countries, including Bangladesh. While the chances of introduction of EVD into Bangladesh may be low, the extremely high population density in the country coupled with inadequate healthcare services and limited infection control practices in most hospitals make Bangladesh highly vulnerable to sustained transmission in the event of importation. To enhance the country’s capacity to detect, respond to, and prevent emerging epidemics of international concern, Bangladesh needs to develop a comprehensive preparedness plan that builds on existing strengths of outbreak response procedures and core capacities of the 2005 International Health Regulations and focus on reducing identified gaps in healthcare delivery.