Publication: Kala azar in Nepal: Estimating the effects of socioeconomic factors on disease incidence
Date
2010
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Background: The incidence of Kala Azar (KA), a neglected tropical infectious disease, describes the pattern of disease,
but is not principally concerned with explaining its causes. The transmission of the infectious diseases is determined
by the complex interactions between environmental and socioeconomic factors. Environmental factors are predicted to
have a significant impact on disease transmission; moreover, socioeconomic factors modify the magnitude and direction
of these impacts. A number of studies have examined possible determinants of KA in endemic countries of the world;
however, most of them appear to have used either qualitative approaches or subjective speculations. None of the studies
indicates in quantitative terms the potential effects of poverty-alleviation programs on the incidence of KA.
Materials and methods: Data related to charecteristics of community were collected from primary as well as secondary
sources. Underlying socioeconomic determints on KA incidence were estimated by exploiting a linear multiple
regression.
Results: The multivariate analysis has confirmed that burden of KA is disproportionately borne by vulnerable and
marginalized groups. KA is most entrenched in the poorest communities. Elimination of KA is directly related to poverty
alleviation because if the poverty incidence reduces by10 percent, it will lead to reduction of KA incidence by 16
percent. The strategy for disease control or elimination should shift from traditional disease-centered approaches to a
holistic approach that can break the links between poverty and KA.
Conclusions: To achieve the target of elimination of KA in Nepal by 2015, the poverty incidence should be reduced
from existing poverty 27 percent to at least 16 percent in KA endemic areas. The association between poverty and KA
reflects causality running in both directions: poverty multiplies KA incidence and KA pushes poor into marginal poor
or further poverty.
Key words: Kala azar, Socioeconomic factors, Leishmaniasis
Description
Adhikari SR 1, Supakankunti S 1 , Khan MM2
1Faculty of Economics, Chulalongkorn University, Thailand, 2Tulane University, New Orleans USA