Table 4: Physician perspectives of VL management.

IndiaNepalBangladeshOverall
20092010200920102009201020092010

No. of physicians interviewed( 𝑛 = 1 9 )( 𝑛 = 2 1 )( 𝑛 = 7 )( 𝑛 = 2 )( 𝑛 = 4 )( 𝑛 = 4 )( 𝑛 = 3 0 )( 𝑛 = 2 7 )
Rk39 test as decision criteria to treat VL18/19
(95%)
13/21
(62%)
7/7
(100%)
2/2
(100%)
4/4
(100%)
4/4
(100%)
29/30
(97%)
19/27
(70%)
Physician’s use of VL drug
  (i) SAG8/19
(42%)
10/21
(48%)
0/7
(0%)
0/2
(0%)
4/4
(100%)
4/4
(100%)
12/30
(40%)
14/27
(52%)
  (ii) Amphotericin B11/19
(58%)
3/21
(14%)
5/7
(71%)
1/2
(50%)
0/4
(0%)
0/4
(0%)
16/30
(53%)
4/27
(15%)
  (iii) Miltefosine17/19
(89%)
20/21
(95%)
5/7
(71%)
1/2
(50%)
0/4
(0%)
4/4
(100%)
22/30
(73%)
25/27
(93%)
Physician criteria for VL drug selection
  (i) Available14/19
(74%)
19/21
(90%)
4/7
(57%)
2/2
(100%)
4/4
(100%)
3/4
(75%)
22/30
(73%)
24/27
(89%)
  (ii) Affordable8/19
(42%)
11/21
(52%)
1/7
(14%)
0/2
(0%)
4/4
(100%)
3/4
(75%)
13/30
(43%)
14/27
(52%)
  (iii) Safe18/19
(95%)
21/21
(100%)
4/7
(57%)
1/2
(50%)
4/4
(100%)
3/4
(75%)
26/30
(87%)
25/27
(93%)
  (iv) Effective12/19
(63%)
12/21
(57%)
4/7
(57%)
1/2
(50%)
4/4
(100%)
3/4
(75%)
20/30
(67%)
16/27
(59%)
No. physician advises blood tests (%)?12/19
(63%)
12/21
(57%)
7/7
(100%)
2/2
(100%)
4/4
(100%)
2/4
(50%)
23/30
(77%)
16/27
(59%)
Reason for not advising blood tests?
 No need4/7
(57%)
1/2
(50%)
4/7
(57%)
1/11
(9%)
 No lab technician9/9
(100%)
1/2
(50%)
10/11
(91%)
No. physician aware of Miltefosine side effects (%)
  (i) Diarrhea19/19
(100%)
21/21
(100%)
5/7
(71%)
2/2
(100%)
0/4
(0%)
0/4
(0%)
24/30
(80%)
23/27
(85%)
  (ii) Vomiting19/19
(100%)
21/21
(100%)
5/7
(71%)
2/2
(100%)
0/4
(0%)
3/4
(75%)
24/30
(80%)
26/27
(96%)
  (iii) Jaundice0/19
(0%)
12/21
(57%)
0/7
(0%)
1/2
(50%)
0/4
(0%)
1/4
(25%)
0/30
(0%)
14/27
(52%)
  (iv) Abdominal pain5/19
(26%)
9/21
(43%)
1/7
(14%)
2/2
(100%)
0/4
(0%)
3/4
(75%)
6/30
(20%)
14/27
(52%)
  (v) Renal toxicity14/19
(74%)
4/21
(19%)
2/7
(29%)
1/2
(50%)
0/4
(0%)
0/4
(0%)
16/30
(53%)
5/27
(19%)
  (vi) Teratogenicity11/19
(58%)
11/21
(52%)
1/7
(14%)
1/2
(50%)
0/4
(0%)
0/4
(0%)
12/30
(40%)
12/27
(44%)
No. physician recommend home based Miltefosine treatment (%)10/19
(53%)
20/21
(95%)
5/7
(71%)
1/2
(50%)
3/4
(75%)
4/4
(100%)
18/30
(60%)
25/27
(93%)
No. physician feel home-based Miltefosine treatment is effective (%)?15/19
(79%)
20/21
(95%)
6/7
(86%)
2/2
(100%)
1/4
(25%)
4/4
(100%)
22/30
(73%)
26/27
(96%)