Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study.
Background In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess the views of stakehold...
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ftdoajarticles:oai:doaj.org/article:ecc60649b79849389e3742ec17b40273 2023-05-15T15:10:50+02:00 Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl 2022-08-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010624 https://doaj.org/article/ecc60649b79849389e3742ec17b40273 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010624 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010624 https://doaj.org/article/ecc60649b79849389e3742ec17b40273 PLoS Neglected Tropical Diseases, Vol 16, Iss 8, p e0010624 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010624 2022-12-30T23:29:50Z Background In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess the views of stakeholders in relation to these treatment options. Methodology In a mixed methods study, we surveyed and interviewed patients, government functionaries, programme managers, health service providers, nongovernmental organizations, researchers, and World Health Organization (WHO) personnel. We used the Evidence to Decision (EtD) framework for data collection planning and analysis. Constructs of interest included valuation of outcomes, impact on equity, feasibility and acceptability of the treatment options, implementation considerations, monitoring and evaluation, and research priorities. Principal findings/conclusion Mortality and non-serious adverse events were rated as "critical" by respectively the highest (61%) and lowest percentages (47%) of survey participants. Participants viewed clinical cure as essential for patients to regain productivity. Non-patient stakeholders emphasized the importance of "sustained" clinical cure. For most survey participants, combination therapy, compared with monotherapy, would increase health equity (40%), and be more acceptable (79%) and feasible (57%). Interviews revealed that combination therapy was more feasible and acceptable than monotherapy when associated with a shorter duration of hospitalization. The findings of the interviews provided insight into those of the survey. When choosing between alternative options, providers should consider the outcomes that matter to patients as well as the impact on equity, feasibility, and acceptability of the options. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 8 e0010624 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
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 Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess the views of stakeholders in relation to these treatment options. Methodology In a mixed methods study, we surveyed and interviewed patients, government functionaries, programme managers, health service providers, nongovernmental organizations, researchers, and World Health Organization (WHO) personnel. We used the Evidence to Decision (EtD) framework for data collection planning and analysis. Constructs of interest included valuation of outcomes, impact on equity, feasibility and acceptability of the treatment options, implementation considerations, monitoring and evaluation, and research priorities. Principal findings/conclusion Mortality and non-serious adverse events were rated as "critical" by respectively the highest (61%) and lowest percentages (47%) of survey participants. Participants viewed clinical cure as essential for patients to regain productivity. Non-patient stakeholders emphasized the importance of "sustained" clinical cure. For most survey participants, combination therapy, compared with monotherapy, would increase health equity (40%), and be more acceptable (79%) and feasible (57%). Interviews revealed that combination therapy was more feasible and acceptable than monotherapy when associated with a shorter duration of hospitalization. The findings of the interviews provided insight into those of the survey. When choosing between alternative options, providers should consider the outcomes that matter to patients as well as the impact on equity, feasibility, and acceptability of the options. |
format |
Article in Journal/Newspaper |
author |
Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl |
author_facet |
Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl |
author_sort |
Joanne Khabsa |
title |
Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
title_short |
Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
title_full |
Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
title_fullStr |
Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
title_full_unstemmed |
Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
title_sort |
stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in hiv-coinfected patients in east africa and south-east asia: a mixed methods study. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010624 https://doaj.org/article/ecc60649b79849389e3742ec17b40273 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 8, p e0010624 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010624 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010624 https://doaj.org/article/ecc60649b79849389e3742ec17b40273 |
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https://doi.org/10.1371/journal.pntd.0010624 |
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PLOS Neglected Tropical Diseases |
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