Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study.
<h4>Background</h4>In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess th...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-08-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0010624 |
| _version_ | 1817985805561364480 |
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| author | Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl |
| author_facet | Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl |
| author_sort | Joanne Khabsa |
| collection | DOAJ |
| description | <h4>Background</h4>In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess the views of stakeholders in relation to these treatment options.<h4>Methodology</h4>In a mixed methods study, we surveyed and interviewed patients, government functionaries, programme managers, health service providers, nongovernmental organizations, researchers, and World Health Organization (WHO) personnel. We used the Evidence to Decision (EtD) framework for data collection planning and analysis. Constructs of interest included valuation of outcomes, impact on equity, feasibility and acceptability of the treatment options, implementation considerations, monitoring and evaluation, and research priorities.<h4>Principal findings/conclusion</h4>Mortality and non-serious adverse events were rated as "critical" by respectively the highest (61%) and lowest percentages (47%) of survey participants. Participants viewed clinical cure as essential for patients to regain productivity. Non-patient stakeholders emphasized the importance of "sustained" clinical cure. For most survey participants, combination therapy, compared with monotherapy, would increase health equity (40%), and be more acceptable (79%) and feasible (57%). Interviews revealed that combination therapy was more feasible and acceptable than monotherapy when associated with a shorter duration of hospitalization. The findings of the interviews provided insight into those of the survey. When choosing between alternative options, providers should consider the outcomes that matter to patients as well as the impact on equity, feasibility, and acceptability of the options. |
| first_indexed | 2024-04-14T00:02:36Z |
| format | Article |
| id | doaj.art-ecc60649b79849389e3742ec17b40273 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-14T00:02:36Z |
| publishDate | 2022-08-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-ecc60649b79849389e3742ec17b402732022-12-22T02:23:40ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352022-08-01168e001062410.1371/journal.pntd.0010624Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study.Joanne KhabsaSaurabh JainAmena El-HarakehCynthia RizkallahDhruv K PandeyNigus ManayeGladys Honein-AbouHaidarChristine HalleuxDaniel Argaw DagneElie A Akl<h4>Background</h4>In visceral leishmaniasis (VL) patients coinfected with human immunodeficiency virus (HIV), combination therapy (liposomal amphotericin B infusion and oral miltefosine) is being considered as an alternative to liposomal amphotericin B monotherapy. We aimed to assess the views of stakeholders in relation to these treatment options.<h4>Methodology</h4>In a mixed methods study, we surveyed and interviewed patients, government functionaries, programme managers, health service providers, nongovernmental organizations, researchers, and World Health Organization (WHO) personnel. We used the Evidence to Decision (EtD) framework for data collection planning and analysis. Constructs of interest included valuation of outcomes, impact on equity, feasibility and acceptability of the treatment options, implementation considerations, monitoring and evaluation, and research priorities.<h4>Principal findings/conclusion</h4>Mortality and non-serious adverse events were rated as "critical" by respectively the highest (61%) and lowest percentages (47%) of survey participants. Participants viewed clinical cure as essential for patients to regain productivity. Non-patient stakeholders emphasized the importance of "sustained" clinical cure. For most survey participants, combination therapy, compared with monotherapy, would increase health equity (40%), and be more acceptable (79%) and feasible (57%). Interviews revealed that combination therapy was more feasible and acceptable than monotherapy when associated with a shorter duration of hospitalization. The findings of the interviews provided insight into those of the survey. When choosing between alternative options, providers should consider the outcomes that matter to patients as well as the impact on equity, feasibility, and acceptability of the options.https://doi.org/10.1371/journal.pntd.0010624 |
| spellingShingle | Joanne Khabsa Saurabh Jain Amena El-Harakeh Cynthia Rizkallah Dhruv K Pandey Nigus Manaye Gladys Honein-AbouHaidar Christine Halleux Daniel Argaw Dagne Elie A Akl Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. PLoS Neglected Tropical Diseases |
| title | Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
| title_full | Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
| title_fullStr | Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
| title_full_unstemmed | Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
| title_short | Stakeholders' views and perspectives on treatments of visceral leishmaniasis and their outcomes in HIV-coinfected patients in East Africa and South-East Asia: A mixed methods study. |
| title_sort | stakeholders views and perspectives on treatments of visceral leishmaniasis and their outcomes in hiv coinfected patients in east africa and south east asia a mixed methods study |
| url | https://doi.org/10.1371/journal.pntd.0010624 |
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