Visceral Leishmaniasis Eradication is a Reality: Data from a Community-based Active Surveillance in Bangladesh

DOI PubMed 1 Citations 32 References
  • Ferdousi Farhana
    Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba
  • Alam Mohammad S.
    Parasitology Laboratory, Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research
  • Hossain Mohammad S.
    Parasitology Laboratory, Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research
  • Ma Enbo
    Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba
  • Itoh Makoto
    Department of Infection and Immunology, Aichi Medical University School of Medicine
  • Mondal Dinesh
    Parasitology Laboratory, Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research
  • Haque Rashidul
    Parasitology Laboratory, Laboratory Sciences Division, International Centre for Diarrhoeal Disease Research
  • Wagatsuma Yukiko
    Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba

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Abstract

More than 20 million people in Bangladesh are considered at risk of developing visceral leishmaniasis (VL). A community-based active surveillance was conducted in eight randomly selected villages in a highly endemic area of Bangladesh from 2006 to 2008. A total of 6,761 individuals living in 1,550 mud-walled houses were included in the active surveillance. Rapid rK39 dipstick tests were conducted throughout the study period to facilitate the case diagnosis. Individuals with previous or current clinical leishmaniasis were identified on the basis of the case definition of the VL elimination program. Untreated cases of suspected VL were referred to the hospital for treatment. Socioeconomic and environmental information including bed net use was also collected. In 2006, the annual incidence of clinical leishmaniasis in the study area was 141.9 cases per 10,000 population, which was significantly increased by the following year owing to community-based active surveillance for case detection and reporting. However, early case detection and early referral for treatment led to a significant decrease in incidence in 2008. This study suggests that community-based active surveillance using a simple diagnostic tool might play a role in achieving the goal of the VL elimination program.

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