Visceral leishmaniasis is a disease that persists in India despite the fact that the WHO elimination target for 2020 is moving ever closer. The National Vector-Borne Disease Control Program has also reported an increase in PDKL cases. Therefore, PKDL cases should be prioritized and this could pose a significant challenge for VL elimination. It is therefore time for policymakers to review strategies and adopt changes where necessary. We extensively examined the healthcare-seeking behavior of PKDL patients as well as treatment delays and their determinants in a low-resource setting with high CVD burden. A much longer time (median: 285 days) was observed for the disease to be confirmed as PKDL, indicating poor health-seeking behavior of patients with PKDL. Similar to our results, a longer delay for patients was observed in another study on PKDL, conducted in Bangladesh. Longer delays have also been reported for breast cancer and tuberculosis. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay A much longer delay in diagnosis of PKDL is of great concern for VL clearance. Because a delay in the diagnosis of VL and PKDL can increase the infectious power, worsen the pathological condition and increase the risk of the appearance of new endemic foci. There is currently no accurate information/data on the burden of PKDL and the existing program is not able to detect or manage PKDL cases at the peripheral level with the limited resources they have. However, early diagnosis and prompt treatment remain essential elements for an effective VL elimination program. Aside from skin changes, PKDL patients do not suffer from any illness or physical discomfort. They only seek treatment when the lesions have intensified or the patients are of marriageable age. Additionally, despite kala-azar in the past, they were not aware of the connection between kala-azar and PKDL. Therefore, effective counseling of patients or their family members during the kala-azar episode is essential. Patients working as laborers or farmers reported a longer time to seek treatment than patients in other occupations (pA significant difference in patient and health system time was observed based on their choice of first health care provider). The possible explanation may be that the trained health workers available at the PHC suspect a person with PKDL during the screening itself and therefore immediately refer the suspected person to the PHC. the nearest available higher center Longer lead time from the health system (median: 802 days) was also obtained in our study. A considerable number of patients in our study first contacted quacks, homeopathic practitioners and. ayurvedic services, which could possibly lead to system delay. It was also found that greater distance from primary health care could possibly increase the delay. seek treatment. However, those who contacted PHC early experienced a shorter time to seek care. Patients with monomorphic skin lesions showed more delay than polymorphic skin lesions. Patients with polymorphic lesions had more disfigurement or.