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Publications

Journal Article Ahead of print

PubMed: 42066583 DOI: 10.1016/j.jiph.2026.103233

Visceral leishmaniasis & HIV co-infection in Bangladesh: Investigating prevalence and policy recommendations.

J Infect Public Health 19(6):103233

Authors: Faria Hossain, Ashik Sharfaraz, Prakash Ghosh, Golam Sarwar, Md Rasel Uddin, Md Utba Rashid, Debashis Ghosh, Rupen Nath, Shomik Maruf, Soumik Kha Sagar, Mohammad Sohel Shomik, Proggananda Nath, Abu Nayeem Mohammad Sohel, Md Sakhawat Hossain, Sharful Islam Khan, Megha Raj Banjara, Christine M Halleux, Abraham Aseffa, Dinesh Mondal

Affiliations

  • Nutrition Research Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
  • Nutrition Research Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh; Institute for Animal Hygiene and Veterinary Public Health, Leipzig University, Leipzig, Germany; Department of Empirical Health Economics, Technische Universität Berlin, Berlin, Germany.
  • Programme for HIV and AIDS, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh; Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA.
  • Mymensingh Medical College and Hospital (MMCH), Mymensingh, Bangladesh.
  • National Kala-azar Elimination Programme, CDC, DGHS, Bangladesh.
  • Programme for HIV and AIDS, Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.
  • Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal; UNICEF/UNDP/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
  • UNICEF/UNDP/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.
  • Nutrition Research Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh.

Abstract

BACKGROUND

Human Immunodeficiency Virus (HIV) co-infection has emerged as a significant challenge in implementing the World Health Organization's (WHO's) strategic interventions to eliminate visceral leishmaniasis (VL) in co-endemic countries. VL-HIV co-infection results in rapid deterioration, higher mortality, and substantially increases the risk of developing VL, facilitating parasite transmission. Although Bangladesh has received official validation for the elimination of VL as a public health problem in 2023, determining the prevalence of VL-HIV co-infection became imperative to develop effective strategies to sustain the elimination status. Therefore, in this study, we aimed to investigate the prevalence of HIV infection in VL patients in Bangladesh.

METHODS

In this cross-sectional study, a total of 656 VL, post kala-azar dermal leishmaniasis (PKDL), and relapsed VL patients were enrolled. and tested for HIV following national HIV testing guidelines. Furthermore, the knowledge and attitudes of 624 participants were assessed through one-to-one interviews using structured questionnaires.

FINDINGS

None of the patients tested positive for VL-HIV co-infection. Only 9.46% of respondents demonstrated comprehensive HIV/AIDS knowledge and 40.06% had positive attitudes towards individuals living with HIV/AIDS. Age, educational status, and home visits by government healthcare workers showed significant positive associations with participants' knowledge and attitudes in multivariate regression analysis.

CONCLUSION

The study found no cases of HIV coinfection among the screened VL cohort in Bangladesh. However, the unavailability or response refusal of 26.1% of previous patients may have introduced significant selection bias. Therefore, considering the substantial health implications and increasing HIV incidence in the general population, we recommend continued routine HIV testing in all VL patients in Bangladesh, aligning with the WHO recommendations. Coordination between the respective national programs is warranted to develop effective strategies to detect emergence of such co-infected cases.

FUNDING

This study was conducted with the financial support of the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR).

MeSH

Research Design, Coinfection, Hiv, Prevalence, Leishmaniasis, Hiv Infections, Leishmaniasis, Visceral, Communicable Diseases, Infections