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Access to leishmaniasis care in Africa. / Sunyoto, Temmy.

Barcelona : Universitat de Barcelona, Spain, 2019. 254 blz.

Onderzoeksoutput: ScriptieDoctoraatsscriptie - Doctoraatsscriptie

Harvard

Sunyoto, T 2019, 'Access to leishmaniasis care in Africa', Doctor in de Filosofie, ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain., Barcelona.

APA

Sunyoto, T. (2019). Access to leishmaniasis care in Africa. Barcelona: Universitat de Barcelona, Spain.

Vancouver

Sunyoto T. Access to leishmaniasis care in Africa. Barcelona: Universitat de Barcelona, Spain, 2019. 254 blz.

Author

Sunyoto, Temmy. / Access to leishmaniasis care in Africa. Barcelona : Universitat de Barcelona, Spain, 2019. 254 blz.

BibTeX

@phdthesis{ca8379f6f3f6419d9701d43572851655,
title = "Access to leishmaniasis care in Africa",
abstract = "Leishmaniasis is a group of diseases caused by an obligate protozoan Leishmania and transmitted by sand flies. As a neglected tropical disease (NTD), leishmaniasis disproportionately affects the poorest populations and those living in rural, remote areas or conflict zones with limited or no access to health care. Manifesting in cutaneous, mucocutaneous or visceral symptoms, the diseases’ complexity and diversity across regions contribute to the challenges in the control efforts. Visceral leishmaniasis (VL) is fatal without treatment, and the indelible scars left by cutaneous leishmaniasis (CL) may have important psycho-social impact. Eastern Africa region currently bears most of the world’s VL burden. However, underestimation of true disease burden is likely, as the paucity of data from unstable contexts may contribute to inaccurate disease estimates. Both VL and CL are known to have limited geographic distribution but may show high variability inter- and intra-countries. Population movement due to conflict or drought, combined with weak or poorly functioning health system have led to epidemics and spread in new areas. Without vaccine or effective vector control, the pillar of control strategy in Africa remains diagnosis and treatment. Access to adequate, quality diagnostic and treatment services in Africa is challenging. The rk39 rapid test is less accurate and treatment options are limited. A 17-day combination of antimonial and paromomycin is the first line treatment for VL in the region, requiring prolonged hospitalisation and increased economic burden for the patients and their households. Despite the progress in tackling NTDs, access to care for leishmaniasis is often taken for granted. Especially in Africa, access remains problematic and the current body of literature shows critical evidence gaps. Low coverage of the health services, accessibility and availability of quality care, limited diagnostic and therapeutic options along with inefficient procurement and supply remain significant challenges in the region. Delay in seeking treatment not only increase morbidity and mortality but also sustain transmission. The hypothesis informing the project is that access to care for leishmaniasis in Africa is still inadequate. The general objectives of this thesis are to improve our understanding on access to care in Africa, by documenting availability, affordability and accessibility of care, explore novel ways of enhancing such care, and provide insights into specific elements of access to formulate coherent policy recommendations for leishmaniasis in eastern Africa. Three specific objectives were formulated: the first is to update the disease burden, second to examine access issues ‘upstream' i.e. the R&D process and third, assess access issues ‘downstream’.",
author = "Temmy Sunyoto",
note = "CPDF",
year = "2019",
language = "English",
publisher = "Universitat de Barcelona, Spain",
school = "ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Cl{\'i}nic-Universitat de Barcelona, Barcelona, Spain.",

}

RIS

TY - THES

T1 - Access to leishmaniasis care in Africa

AU - Sunyoto, Temmy

N1 - CPDF

PY - 2019

Y1 - 2019

N2 - Leishmaniasis is a group of diseases caused by an obligate protozoan Leishmania and transmitted by sand flies. As a neglected tropical disease (NTD), leishmaniasis disproportionately affects the poorest populations and those living in rural, remote areas or conflict zones with limited or no access to health care. Manifesting in cutaneous, mucocutaneous or visceral symptoms, the diseases’ complexity and diversity across regions contribute to the challenges in the control efforts. Visceral leishmaniasis (VL) is fatal without treatment, and the indelible scars left by cutaneous leishmaniasis (CL) may have important psycho-social impact. Eastern Africa region currently bears most of the world’s VL burden. However, underestimation of true disease burden is likely, as the paucity of data from unstable contexts may contribute to inaccurate disease estimates. Both VL and CL are known to have limited geographic distribution but may show high variability inter- and intra-countries. Population movement due to conflict or drought, combined with weak or poorly functioning health system have led to epidemics and spread in new areas. Without vaccine or effective vector control, the pillar of control strategy in Africa remains diagnosis and treatment. Access to adequate, quality diagnostic and treatment services in Africa is challenging. The rk39 rapid test is less accurate and treatment options are limited. A 17-day combination of antimonial and paromomycin is the first line treatment for VL in the region, requiring prolonged hospitalisation and increased economic burden for the patients and their households. Despite the progress in tackling NTDs, access to care for leishmaniasis is often taken for granted. Especially in Africa, access remains problematic and the current body of literature shows critical evidence gaps. Low coverage of the health services, accessibility and availability of quality care, limited diagnostic and therapeutic options along with inefficient procurement and supply remain significant challenges in the region. Delay in seeking treatment not only increase morbidity and mortality but also sustain transmission. The hypothesis informing the project is that access to care for leishmaniasis in Africa is still inadequate. The general objectives of this thesis are to improve our understanding on access to care in Africa, by documenting availability, affordability and accessibility of care, explore novel ways of enhancing such care, and provide insights into specific elements of access to formulate coherent policy recommendations for leishmaniasis in eastern Africa. Three specific objectives were formulated: the first is to update the disease burden, second to examine access issues ‘upstream' i.e. the R&D process and third, assess access issues ‘downstream’.

AB - Leishmaniasis is a group of diseases caused by an obligate protozoan Leishmania and transmitted by sand flies. As a neglected tropical disease (NTD), leishmaniasis disproportionately affects the poorest populations and those living in rural, remote areas or conflict zones with limited or no access to health care. Manifesting in cutaneous, mucocutaneous or visceral symptoms, the diseases’ complexity and diversity across regions contribute to the challenges in the control efforts. Visceral leishmaniasis (VL) is fatal without treatment, and the indelible scars left by cutaneous leishmaniasis (CL) may have important psycho-social impact. Eastern Africa region currently bears most of the world’s VL burden. However, underestimation of true disease burden is likely, as the paucity of data from unstable contexts may contribute to inaccurate disease estimates. Both VL and CL are known to have limited geographic distribution but may show high variability inter- and intra-countries. Population movement due to conflict or drought, combined with weak or poorly functioning health system have led to epidemics and spread in new areas. Without vaccine or effective vector control, the pillar of control strategy in Africa remains diagnosis and treatment. Access to adequate, quality diagnostic and treatment services in Africa is challenging. The rk39 rapid test is less accurate and treatment options are limited. A 17-day combination of antimonial and paromomycin is the first line treatment for VL in the region, requiring prolonged hospitalisation and increased economic burden for the patients and their households. Despite the progress in tackling NTDs, access to care for leishmaniasis is often taken for granted. Especially in Africa, access remains problematic and the current body of literature shows critical evidence gaps. Low coverage of the health services, accessibility and availability of quality care, limited diagnostic and therapeutic options along with inefficient procurement and supply remain significant challenges in the region. Delay in seeking treatment not only increase morbidity and mortality but also sustain transmission. The hypothesis informing the project is that access to care for leishmaniasis in Africa is still inadequate. The general objectives of this thesis are to improve our understanding on access to care in Africa, by documenting availability, affordability and accessibility of care, explore novel ways of enhancing such care, and provide insights into specific elements of access to formulate coherent policy recommendations for leishmaniasis in eastern Africa. Three specific objectives were formulated: the first is to update the disease burden, second to examine access issues ‘upstream' i.e. the R&D process and third, assess access issues ‘downstream’.

M3 - Doctoral dissertation - Doctoral dissertation

PB - Universitat de Barcelona, Spain

CY - Barcelona

ER -

ID: 3097428