Quality of life perceptions amongst patients co-infected with Visceral Leishmaniasis and HIV: A qualitative study from Bihar, India.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read Online Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
    • Publication Information:
      Original Publication: San Francisco, CA : Public Library of Science
    • Subject Terms:
      Perception* ; Qualitative Research* ; Quality of Life*; Coinfection/*epidemiology ; HIV Infections/*epidemiology ; Leishmaniasis, Visceral/*epidemiology; Acute Disease ; Adolescent ; Adult ; Anxiety/etiology ; Female ; Government ; HIV Infections/economics ; HIV Infections/psychology ; Health Expenditures ; Humans ; India/epidemiology ; Leishmaniasis, Visceral/diagnosis ; Leishmaniasis, Visceral/economics ; Leishmaniasis, Visceral/psychology ; Male ; Middle Aged ; Private Sector ; Social Networking ; Social Stigma ; Social Support ; Young Adult
    • Abstract:
      Background: Co-infection with Visceral Leishmaniasis (commonly known as Kala Azar, KA) and Human Immunodeficiency Virus (HIV) is increasingly being diagnosed among patients in Bihar. This qualitative study is the first assessment of self-reported quality of life among patients co-infected with KA-HIV in the Asian context.
      Methods: We conducted semi-structured, in-depth interviews and adopted an inductive thematic analysis to generate evidence on the quality of life of patients co-infected with KA and HIV. Patients were purposively sampled until saturation was attained.
      Results: We found that patients highly valued income or livelihood potential and health as indicators of a good quality life, and routinely went into debt accessing care in the private setup. This was due to perceptions of poor quality of care in the government setup and a lack of knowledge regarding available government services at the district level. KA symptoms were often misdiagnosed in the private sector as seasonal fever, while care providers found it difficult to disentangle the clinical symptoms of KA and HIV; hence, patients presented late to district hospitals. Patients perceived a high level of stigma, largely due to their HIV status, and routinely reported that HIV had "destroyed" their life.
      Conclusions: Inadequate social support and referral pathways that were not conducive to patient needs negatively impacted patients' quality of life. The dual burden of poverty interacting with the severity and chronicity of KA-HIV co-infection means financial support, increased community engagement, and collaborative decision making are crucial for co-infected patients. Increased provider awareness of co-infection and effective stigma-reduction interventions should be integrated to ensure that appropriate and effective access to care is possible for this vulnerable population. A sustainable long-term strategy requires a people-centered approach wherein the perceptions and life circumstances of patients are taken into account in the medical decision making process.
      Competing Interests: The authors have declared that no competing interests exist.
    • References:
      BMJ Open. 2012 Sep 30;2(5):. (PMID: 23028110)
      Curr Opin Infect Dis. 2013 Feb;26(1):1-9. (PMID: 23221770)
      Clin Infect Dis. 2014 Aug 15;59(4):552-5. (PMID: 24814660)
      BMC Public Health. 2017 Feb 16;17(1):204. (PMID: 28209209)
      Open Forum Infect Dis. 2018 Mar 16;5(4):ofy059. (PMID: 29732379)
      HIV AIDS (Auckl). 2018 Oct 15;10:193-201. (PMID: 30410407)
      Health Millions. 1994 Feb;2(1):10-2. (PMID: 12288588)
      Trans R Soc Trop Med Hyg. 2000 Nov-Dec;94(6):696-7. (PMID: 11198660)
      Health Policy Plan. 2010 Sep;25(5):437-46. (PMID: 20350934)
      Parasit Vectors. 2016 Jan 27;9:25. (PMID: 26812963)
      Front Immunol. 2012 Apr 17;3:80. (PMID: 22566961)
      Trans R Soc Trop Med Hyg. 2006 Sep;100(9):838-41. (PMID: 16406035)
      Parasitol Res. 2018 Aug;117(8):2591-2595. (PMID: 29860572)
      Clin Microbiol Rev. 2008 Apr;21(2):334-59, table of contents. (PMID: 18400800)
      PLoS Negl Trop Dis. 2014 Sep 18;8(9):e3136. (PMID: 25233461)
      J Acquir Immune Defic Syndr. 2003 Apr 15;32(5):572-3. (PMID: 12679712)
      HIV AIDS (Auckl). 2016 Oct 07;8:147-156. (PMID: 27785103)
      Clin Infect Dis. 2015 Oct 15;61(8):1255-62. (PMID: 26129756)
      PLoS Pathog. 2012;8(4):e1002635. (PMID: 22496656)
      Soc Sci Med. 2011 Feb;72(3):327-37. (PMID: 21071126)
      J Med Microbiol. 2006 Jul;55(Pt 7):919-22. (PMID: 16772420)
      Indian J Med Res. 2017 Dec;146(6):759-767. (PMID: 29664035)
      PLoS One. 2017 Nov 17;12(11):e0187904. (PMID: 29149181)
      AIDS. 2006 May 12;20(8):1213-5. (PMID: 16691082)
      PLoS Negl Trop Dis. 2018 May 10;12(5):e0006375. (PMID: 29746470)
      PLoS Negl Trop Dis. 2014 Aug 07;8(8):e3053. (PMID: 25101665)
      Lancet. 2018 Sep 15;392(10151):951-970. (PMID: 30126638)
      J Glob Infect Dis. 2011 Jan;3(1):19-24. (PMID: 21572604)
    • Publication Date:
      Date Created: 20200211 Date Completed: 20200422 Latest Revision: 20200422
    • Publication Date:
      20240105
    • Accession Number:
      PMC7010301
    • Accession Number:
      10.1371/journal.pone.0227911
    • Accession Number:
      32040525