Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study.
BACKGROUND:Ethiopia bears a high burden of visceral leishmaniasis (VL). Early access to VL diagnosis and care improves clinical prognosis and reduces transmission from infected humans; however, significant obstacles exist. The approximate 250,000 seasonal mobile workers (MW) employed annually in nor...
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ftdoajarticles:oai:doaj.org/article:34292bdc224b4c2cb43f90d975f69f4e 2023-05-15T15:12:25+02:00 Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. Rebecca Marie Coulborn Tesfay Gebregzabher Gebrehiwot Martin Schneider Sibylle Gerstl Cherinet Adera Mercè Herrero Klaudia Porten Margriet den Boer Koert Ritmeijer Jorge Alvar Abrahim Hassen Afework Mulugeta 2018-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006778 https://doaj.org/article/34292bdc224b4c2cb43f90d975f69f4e EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC6224040?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006778 https://doaj.org/article/34292bdc224b4c2cb43f90d975f69f4e PLoS Neglected Tropical Diseases, Vol 12, Iss 11, p e0006778 (2018) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2018 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006778 2022-12-31T00:16:39Z BACKGROUND:Ethiopia bears a high burden of visceral leishmaniasis (VL). Early access to VL diagnosis and care improves clinical prognosis and reduces transmission from infected humans; however, significant obstacles exist. The approximate 250,000 seasonal mobile workers (MW) employed annually in northwestern Ethiopia may be particularly disadvantaged and at risk of VL acquisition and death. Our study aimed to assess barriers, and recommend interventions to increase access, to VL diagnosis and care among MWs. METHODOLOGY/PRINCIPAL FINDINGS:In 2017, 50 interviews and 11 focus group discussions were conducted with MWs, mobile residents, VL patients and caretakers, community leaders and healthcare workers in Kafta Humera District, Tigray. Participants reported high vulnerability to VL among MWs and residents engaged in transitory work. Multiple visits to health facilities were consistently needed to access VL diagnosis. Inadequate healthcare worker training, diagnostic test kit unavailability at the primary healthcare level, lack of VL awareness, insufficient finances for care-seeking and prioritization of income-generating activities were significant barriers to diagnosis and care. Social (decision-making and financial) support strongly and positively influenced care-seeking; workers unable to receive salary advances, compensation for partial work, or peer assistance for contract completion were particularly disadvantaged. Participants recommended the government/stakeholders intervene to ensure: MWs access to bed-nets, food, shelter, water, and healthcare at farms or sick leave; decentralization of diagnostic tests to primary healthcare facilities; surplus medications/staff during the peak season; improved referral/feedback/reporting/training within the health system; free comprehensive healthcare for all VL-related services; and community health education. CONCLUSIONS/SIGNIFICANCE:Contrary to what health policy for VL dictates in this endemic setting, study participants reported very poor access to diagnosis and, ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 12 11 e0006778 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Rebecca Marie Coulborn Tesfay Gebregzabher Gebrehiwot Martin Schneider Sibylle Gerstl Cherinet Adera Mercè Herrero Klaudia Porten Margriet den Boer Koert Ritmeijer Jorge Alvar Abrahim Hassen Afework Mulugeta Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Ethiopia bears a high burden of visceral leishmaniasis (VL). Early access to VL diagnosis and care improves clinical prognosis and reduces transmission from infected humans; however, significant obstacles exist. The approximate 250,000 seasonal mobile workers (MW) employed annually in northwestern Ethiopia may be particularly disadvantaged and at risk of VL acquisition and death. Our study aimed to assess barriers, and recommend interventions to increase access, to VL diagnosis and care among MWs. METHODOLOGY/PRINCIPAL FINDINGS:In 2017, 50 interviews and 11 focus group discussions were conducted with MWs, mobile residents, VL patients and caretakers, community leaders and healthcare workers in Kafta Humera District, Tigray. Participants reported high vulnerability to VL among MWs and residents engaged in transitory work. Multiple visits to health facilities were consistently needed to access VL diagnosis. Inadequate healthcare worker training, diagnostic test kit unavailability at the primary healthcare level, lack of VL awareness, insufficient finances for care-seeking and prioritization of income-generating activities were significant barriers to diagnosis and care. Social (decision-making and financial) support strongly and positively influenced care-seeking; workers unable to receive salary advances, compensation for partial work, or peer assistance for contract completion were particularly disadvantaged. Participants recommended the government/stakeholders intervene to ensure: MWs access to bed-nets, food, shelter, water, and healthcare at farms or sick leave; decentralization of diagnostic tests to primary healthcare facilities; surplus medications/staff during the peak season; improved referral/feedback/reporting/training within the health system; free comprehensive healthcare for all VL-related services; and community health education. CONCLUSIONS/SIGNIFICANCE:Contrary to what health policy for VL dictates in this endemic setting, study participants reported very poor access to diagnosis and, ... |
format |
Article in Journal/Newspaper |
author |
Rebecca Marie Coulborn Tesfay Gebregzabher Gebrehiwot Martin Schneider Sibylle Gerstl Cherinet Adera Mercè Herrero Klaudia Porten Margriet den Boer Koert Ritmeijer Jorge Alvar Abrahim Hassen Afework Mulugeta |
author_facet |
Rebecca Marie Coulborn Tesfay Gebregzabher Gebrehiwot Martin Schneider Sibylle Gerstl Cherinet Adera Mercè Herrero Klaudia Porten Margriet den Boer Koert Ritmeijer Jorge Alvar Abrahim Hassen Afework Mulugeta |
author_sort |
Rebecca Marie Coulborn |
title |
Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. |
title_short |
Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. |
title_full |
Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. |
title_fullStr |
Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. |
title_full_unstemmed |
Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. |
title_sort |
barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in western tigray, northern ethiopia: a qualitative study. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2018 |
url |
https://doi.org/10.1371/journal.pntd.0006778 https://doaj.org/article/34292bdc224b4c2cb43f90d975f69f4e |
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Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
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PLoS Neglected Tropical Diseases, Vol 12, Iss 11, p e0006778 (2018) |
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http://europepmc.org/articles/PMC6224040?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006778 https://doaj.org/article/34292bdc224b4c2cb43f90d975f69f4e |
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https://doi.org/10.1371/journal.pntd.0006778 |
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PLOS Neglected Tropical Diseases |
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