Contributing+Factors+-+Leishmaniasis

Drug/ treatment factors: Leishmaniasis is a difficult disease to treat in that the treatments are all toxic, with significant side effects. There are drug resistant strains, but most cases can be cured with the drug regiment of antimony compounds. Nevertheless, it is considered an orphan disease meaning that there is low incidence in wealthy countries and first world areas such that the pharmaceutical industry finds little financial incentive to invest in possible cures or treatments.

Environmental Factors: Many people who are afflicted live in remote areas such as the hills of Afghanistan where the road system is poor and access to doctors is extremely limited.

Delay between bite and symptoms: In addition, the visceral form of the disease that is systemic does not manifest until 2 months after the bite. As symptoms afflict victims, diagnosis can be delayed due to no recollection of the initial bite.

Failure to complete treatment/ drug resistance: Failure to complete treatment often results in a drug resistant strain of leishmaniasis because the strongest pathogens can survive the initial stages of treatment and can be dangerous to a person's immune system if left alone/ untreated.

Social and economic factors: Afghanistan is a very poor country and many of its inhabitants who are infected by leishmaniasis do not have money for proper treatment. In addition, many people within Afghanistan are not educated on how to treat and respond to the disease if they are infected. Even if a person within the country of Afghanistan is aware that they have contracted leishmaniasis, it would be extremely difficult and costly to attain proper medical equipment to identify what strain of leishmaniasis they are infected with in order to prescribe effective treatment. In addition to the economic factors that inhibit people within Afghanistan from treating and identifying leishmaniasis, there is also a prevalent clash between social norms and medecine that exists within this country. Because Afghanistan is a very conservative Muslim nation, women are prohibited from medical examination by male doctors. Most doctors and educated persons within Afghanistan are male because women are mostly not allowed to attend school. In turn, it is very difficult to diagnose leishmaniasis and any disease that infects a woman within Afghanistan because religious and social institutions prevent them from seeing a male doctor.In addition, many religious people are against medicine due to the belief that disease and infection are punishments from God that one should not fight against.

Stigma factor: Lastly, there is a stigma attached to many infectious diseases like leishmaniasis that have physical indications. Many people who have leishmaniasis are shunned by their community and isolated, inhibiting them from attaining medical help and attention.

Sand fly prevalence: It is very difficult to avoid being bitten by sand-flies, and prevent the disease from being transmitted if you are in an environment where sand flies exist.

Leishmaniasis + HIV: One factor that contributes to the prevalence of Leishmaniasis globally and within Afghanistan is its interaction with HIV. Contracting an HIV infection increases an individual's risk of developing active leishmaniasis by 100 to 2320 times.