RISK FACTORS FOR INDIAN KALA-AZAR

Parasites & Vectors, 2010

Background: In visceral leishmaniasis (VL), phlebotomine vectors are the main target to reduce for control measures. An attempt has been taken to delineate the association between Phlebotomous argentipes and housing characteristics between two districts e.g. endemic and non-endemic. Methods: A cross-sectional survey was conducted on 240 households for both the endemic (Vaishali district) and non-endemic (Lohardaga district) site. Logistic regression analysis was used to identify factors related to housing characteristics influencing suitable habitats for P. argentipes. Vector density estimated using a CDC light trap. Results: The proportion of P. argentipes in both endemic and non-endemic areas was significantly much higher (P < 0.001) when compared with the proportion of Sergentomiya and P. papatasi. The results of multilevel logistic regression analysis showed that mud plastered wall (P value = 0.001), mixed dwelling (P value = 0.002) and area (P value = 0.001) were strongly associated with the presence of vectors. Conclusion: Result of the studied household characteristics provides an accurate, rapid assessment of house-level variation in risk. The results also have implications for maximizing surveillance efficacy of sandflies, which is likely to become increasingly important while formulating any control strategy.

PLOS Neglected Tropical Diseases, 2020

Background Visceral leishmaniasis (VL) or Kala-azar has been a major public health problem in Bihar, India, for several decades. A few VL infected districts including Vaishali have reported >600 cases annually. Hence, in 2015, the Government of India entrusted ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, to implement an integrated control strategy for achieving the VL elimination target (<1 case per 10,000 people at the block level) in the Vaishali District of Bihar. Methodology This study was conducted between January 2015 and December 2016. An integrated control strategy including the spatio-temporal mapping of VL-case distribution, active case detection, chemical-based vector control using indoor residual spraying (IRS), community awareness campaigns, the training of IRS members, the training of medical doctors for effective treatment, daily monitoring and the supervision of IRS activities, logistic management, post-IRS quality assurance, epidemiological surveillance, and entomological monitoring was performed. An insecticide quantification test was performed for evaluating the IRS quality on sprayed walls. A modern compression pump was used to maintain spray quality on different wall surfaces. The impact of IRS was assessed through sand fly collection in human dwellings and cattle sheds in pre-and post-IRS. The insecticide susceptibility of local P. argentipes was performed before each IRS round (in February and June) during 2015-2016. Statistical analysis such as the mean, percentage, and 95% CI were used to summarize the results.

Tropical Medicine and International Health, 2006

objective To evaluate five kala-azar serological tests for field use. method Serological survey in Pandit Ka Purva village in Varanasi district, India, using Sia water test, aldehyde test, direct agglutination test (DAT), micro-enzyme-linked immunosorbent assay (ELISA) and dot-ELISA.

MFC Bulletin, 2014

The Indian Journal of Pediatrics, 2000

of a large number of kala-azar cases from one particular village in Varanasi district, Uttar Pradesh, led us to carry out an epidemiological study of the situation using standard techniques. The overall prevalence and case fatality of the disease were 12.9% and 10.5%, respectively. A history of fever and hepatosplenomegaly was noted for all the cases. The case definition was the presence of parasites in bone marrow or splenic aspirate smears. The disease was more prevalent among adults, but occurred also among children. However, there was no clear linear relationship between the prevalence of the disease and age group. Kalaazar occurred among males and females, and its prevalence did not correlate significantly with income. Since the disease vector continues to be present in the study area, the health authorities should take strong steps to control the disease. Voir page 373 le re sume en franc Ëais. En la pa gina 373 figura un resumen en espan Ä ol.

American Journal of Tropical Medicine and Hygiene, 2018

To assess the knowledge, attitude, and preventive practices related to kala-azar in Madhepura district of Bihar, a community-based cross-sectional study was carried out in November 2014. A total of 353 households were interviewed from 24 villages of four blocks of Madhepura district. Data were collected using structured interview schedule. For knowledge, attitude, and preventive practice indexes, scores were assigned to individual questions based on the accuracy of responses. Univariate and binary logistic regressions were applied for the analysis. Eighty-four percent households had heard of kala-azar disease, but only 15.9% could recognize that sand flies were responsible for transmitting the disease. Overall, only 43.9% had fair knowledge on kala-azar disease (e.g., mode of transmission, signs and symptoms, and the outcome if left untreated) and the vector (breeding place, season, and biting time). Almost 48.6% had a favorable attitude toward treatability and management of kala-azar and 37.7% practiced proper mechanism to prevent and control kala-azar. Occupation emerged as a significant predictor for all three indexes. Other important predictors for the attitude index were literacy, household type, households ever had a kala-azar case, and knowledge index. Despite 61.8% of the households ever reported to have a member diagnosed with kala-azar, the overall knowledge of the disease and vector, attitude, and practices about prevention and control of kala-azar was found to be lagging. Therefore, our investigation suggests that further strengthening of comprehensive knowledge about kala-azar and preventive practices is needed.

Tropical Medicine and International Health, 2004

We conducted a sero-epidemiological study of kala-azar in two endemic communities (Kasaini and Gidhaniya) situated in the Terai (plain) of eastern Nepal. Direct agglutination test (DAT) was used as a serological test for screening. Capillary blood samples were collected by filter paper method from 601 (96%) people of a total population of 628 in Kasaini and from 482 (94%) people of 515 in Gidhaniya. Positive DAT titres were found in 66 (6.09%) of 1083 sera tested. The male-female seroprevalence ratio was 1.44:1 and the age group of 15 years and above was most affected. Among the bone marrow aspirates collected from 66 DAT seropositive cases, only 19 were positive for Leishmania donovani (LD bodies). Of the 47 DAT seropositive but LD bodies' negative cases, three were clinically active cases of kala-azar. Another nine developed clinical symptoms of kala-azar during 6 months follow-up and 23 were cases that had received prior treatment for kala-azar (within 1 year). The results of this study show the potential of the DAT on filter paper as a screening test for the surveillance of kala-azar at a community level.

2005

Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over a 3-year period in a Bangladeshi community. By history, active case detection, and serologic screening, 155 of 2,356 residents had kala-azar with onset from 2000 to 2003. Risk was highest for persons 3-45 years of age, and no significant difference by sex was seen. In age-adjusted multivariable models, 3 factors were identified: proximity to a previous kala-azar patient (odds ratio [OR] 25.4, 95% confidence interval [CI] 15-44 within household; OR 3.2 95% CI 1.7-6.1 within 50 m), bed net use in summer (OR 0.7, 95% CI 0.53-0.93), and cattle per 1,000 m 2 (OR 0.8, 95% CI 0.70-0.94]). No difference was seen by income, education, or occupation; land ownership or other assets; housing materials and condition; or keeping goats or chickens inside bedrooms. Our data confirm strong clustering and suggest that insecticide-treated nets could be effective in preventing kala-azar. S ince 1990, South Asia has experienced a resurgence of the lethal parasitic disease visceral leishmaniasis (VL). India, Bangladesh, and Nepal account for an estimated 300,000 cases annually and 60% of the global burden (in terms of disability-adjusted life years lost) of VL (1,2). Superimposed on this poorly controlled VL-endemic situation are outbreaks that affect hundreds of thousands of people, as in Bihar in the early 1990s (3). The full-blown clinical syndrome caused by VL is characterized by fever, weight loss, splenomegaly, hepatomegaly, skin darkening, and anemia and is known as kala-azar ("black fever" in Hindi). Kala-azar is nearly always fatal if untreated (4). Even with treatment, case-fatality rates often exceed 10% in VL-endemic areas of Asia and Africa (5). Leishmania donovani is transmitted by the female sand fly, and humans are the only reservoir in South Asia (6). Blanket residual insecticide spraying decreased the incidence of kala-azar below detectable levels in India and Bangladesh by the 1960s (3), which suggests that sustained vector control could substantially reduce disease prevalence today. Efforts to control this neglected disease have recently gained momentum from the government of India's commitment to eliminate kala-azar by the year 2010 (7). Nevertheless, data on the epidemiology of anthroponotic VL are sparse. To plan effective strategies for VL control and elimination, we must understand patterns of disease occurrence both at the community level and at broader geographic and ecologic levels. To elucidate the determinants at the community level, we studied spatial patterns and risk factors for kala-azar in a highly affected community in Bangladesh. Methods The study design was based on cross-sectional household surveys from January to April in 2002, 2003, and 2004. The surveys included leishmaniasis serologic studies and active kala-azar case detection. The study physician (M.A.) was present during the surveys and at regular intervals between surveys and offered free diagnosis for residents with suspected kala-azar; thus, additional ascertainment occurred between surveys. The protocol was approved by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) Research and Ethical Review Committees and the Institutional Review Board of the Centers for Disease Control and Prevention (CDC). Informed consent was obtained from all adult participants and a parent or guardian of all participating children. Assent was also obtained from children >7 years of age. The study community is located in Fulbaria Thana, Mymensingh District, the "thana" (subdistrict) that has

International Journal Of Medical Science And Clinical Research Studies

Background According to World Health Organization, an estimated 700000 to 1 million new cases and 26000 to 65000 deaths occur annually from Kala-azar. In the countries of South-East Asia region, Kala-azar occurs mainly in three countries- India, Bangladesh and Nepal. The disease occurs in agricultural villages where houses are frequently constructed with mud walls. Even people residing in endemic areas have poor practices for its prevention. Methods A descriptive cross-sectional study was conducted among 150 community people of Katahari Gaupalika, Morang. Simple Random sampling technique was used for the selection of three wards among seven wards, probability proportionate was used for the selection of the population from the ward. The desired sample was selected purposively. Data were collected from face-to-face interview techniques using a structured questionnaire. Statistical analysis was done by using SPSS 16 version. Results It is found that nearly two-thirds of the respondents...

Background: Visceral Leishmaniasis (VL), commonly known as Kala-azar is a chronic febrile disease occurs widely throughout the world. There are many risk factors which can influence the causation of kala azar in Bangladeshi people. The aim of the present study is to describe the Sociodemographic, household and environmental risk factors of kala-azar among a case series of Bangladeshi patients. Method: This case control study was carried out at inpatient department of Community Based Medical College Hospital,