01913nas a2200217   4500000000100000008004100001653003800042653002700080653002600107653001200133653001400145100001400159700001200173700001500185245008400200856009800284300001300382490000700395520127900402022001401681       2017                            d10aNeglected Tropical Diseases (NTD)10aVisceral Leishmaniasis10aAccess to health care10aSomalia10adiagnosis1 aSunyoto T1 aPotet J1 aBoelaert M00aVisceral leishmaniasis in Somalia: A review of epidemiology and access to care.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005231&type=printable  ae00052310 v113 a<p>Somalia, ravaged by conflict since 1991, has areas endemic for visceral leishmaniasis (VL), a deadly parasitic disease affecting the rural poor, internally displaced, and pastoralists. Very little is known about VL burden in Somalia, where the protracted crisis hampers access to health care. We reviewed evidence about VL epidemiology in Somalia and appraised control options within the context of this fragile state's health system. VL has been reported in Somalia since 1934 and has persisted ever since in foci in the southern parts of the country. The only feasible VL control option is early diagnosis and treatment, currently mostly provided by nonstate actors. The availability of VL care in Somalia is limited and insufficient at best, both in coverage and quality. Precarious security remains a major obstacle to reach VL patients in the endemic areas, and the true VL burden and its impact remain unknown. Locally adjusted, innovative approaches in VL care provision should be explored, without undermining ongoing health system development in Somalia. Ensuring VL care is accessible is a moral imperative, and the limitations of the current VL diagnostic and treatment tools in Somalia and other endemic settings affected by conflict should be overcome.</p>
  a1935-2735