02951nas a2200265   4500000000100000008004100001260001200042653003000054653002000084653001300104653002700117100001200144700001500156700001200171700002200183700001200205700001400217700001400231245014800245856008900393300000900482490000700491520217300498022001402671       2024                            d  c09/202410aBarriers and facilitators10aCase management10aEthiopia10aVisceral Leishmaniasis1 aGelaw Y1 aGangneux J1 aAlene G1 aRobert-Gangneux F1 aDawed A1 aHussien M1 aEnbiale W00aBarriers and facilitators of visceral leishmaniasis case management in the Amhara Region, Northwest Ethiopia: an exploratory qualitative study.  uhttps://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-20055-1.pdf  a1-170 v243 a<p><strong>Background: </strong>Visceral leishmaniasis (VL) is among the world's most serious public health threats, causing immense human suffering and death. In Ethiopia, little is known about the barriers and facilitators of visceral leishmaniasis case management. This study aimed to explore such barriers and facilitators in the Amhara Regional State, Northwest Ethiopia.</p>

<p><strong>Methods: </strong>An exploratory qualitative study was conducted on 16 purposively selected patients and key informants from May 8 to June 2, 2023. The study participants were recruited using the maximum variation technique. The interviews were audio recorded, transcribed verbatim, and translated into English. Thematic analysis was employed using Atlas.ti 9 software with a blended approach of both deductive and inductive coding.</p>

<p><strong>Results: </strong>The study identified a variety of issues that hinder the success of visceral leishmaniasis case management. Treatment centers face frequent interruptions of medicinal supplies, a lack of funding, and a lack of trained healthcare providers. A lack of support from health authorities, including weak supervision and feedback systems, is also a source of concern. Most patients receive treatments after significant delays, which is primarily due to low awareness, poor surveillance, and misdiagnosis by healthcare workers. The case management is further constrained by malnutrition, VL-HIV co-infection, and other comorbidities. Despite these issues, we found that effective collaboration between hospital units and VL treatment centers, acceptance by hospitals, and the caring attitude of healthcare workers play a positive role in facilitating the program's effectiveness.</p>

<p><strong>Conclusions: </strong>Despite the existence of certain efforts that facilitate the program's effectiveness, VL remains largely neglected, with little government attention or intervention. Such inattention is the root cause of most of the issues. Despite limited resources, most issues could be resolved with cost-effective strategies if health authorities at all levels have the will and commitment to do so.</p>
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