Gerstl S, Amsalu R, Ritmeijer K
Médecins Sans Frontières Holland, Amsterdam, The Netherlands.
Trop Med Int Health. 2006 Feb;11(2):167-75. doi: 10.1111/j.1365-3156.2005.01550.x.
To evaluate the accessibility of visceral leishmaniasis (VL) treatment.
Community-based study using in-depth qualitative interviews and focus group discussions with key informants, as well as quantitative questionnaires with 448 randomly selected heads of households in nine representative villages in three geographical sub-regions.
Despite the high incidence of the disease, most people in Gedaref State know little about VL, and help at a treatment centre is usually sought only after traditional remedies and basic allopathic drugs have failed. Factors barring access to treatment are: lack of money for treatment and transport, impassability of roads, work priorities, severe cultural restrictions of women's decision-making power and distance to the next health center.
To provide more VL patients with access to treatment in this highly endemic area, diagnostic and treatment services should be decentralized. Health education would be a useful tool to rationalise people's health-seeking behaviour.
评估内脏利什曼病（VL）治疗的可及性。
采用基于社区的研究，对关键信息提供者进行深入的定性访谈和焦点小组讨论，并对三个地理次区域九个代表性村庄中随机抽取的448户家庭户主进行定量问卷调查。
尽管该病发病率很高，但加达里夫州的大多数人对VL了解甚少，通常只有在传统疗法和基本的对抗疗法药物无效后才会寻求治疗中心的帮助。阻碍获得治疗的因素包括：缺乏治疗和交通费用、道路不通、工作优先事项、妇女决策权受到严格文化限制以及到下一个健康中心的距离。
为了使这个高流行地区更多的VL患者能够获得治疗，应将诊断和治疗服务分散。健康教育将是使人们的就医行为合理化的有用工具。
