Visceral leishmaniasis outbreaks in Bihar: community-level investigations in the context of elimination of kala-azar as a public health problem
| العنوان: | Visceral leishmaniasis outbreaks in Bihar: community-level investigations in the context of elimination of kala-azar as a public health problem |
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| المؤلفون: | Joy Bindroo, Sridhar Srikantiah, Madan Prashad Sharma, Caryn Bern, Tanmay Mahapatra, Allen W. Hightower, Pushkar Dubey, Khushbu Priyamvada, Lloyd A. C. Chapman |
| المصدر: | Parasites & Vectors Parasites & Vectors, Vol 14, Iss 1, Pp 1-11 (2021) |
| بيانات النشر: | Springer Science and Business Media LLC, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, medicine.medical_specialty, Adolescent, Epidemiology, 030231 tropical medicine, Population, Outbreak investigation, India, Context (language use), Biology, lcsh:Infectious and parasitic diseases, Disease Outbreaks, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Environmental health, medicine, Humans, lcsh:RC109-216, Longitudinal Studies, Disease Eradication, Risk factor, Child, education, Visceral leishmaniasis, Family Characteristics, education.field_of_study, Research, Incidence, Public health, Incidence (epidemiology), Age Factors, Outbreak, Middle Aged, medicine.disease, Crowding, 030104 developmental biology, Infectious Diseases, Risk factors, Child, Preschool, Leishmaniasis, Visceral, Female, Parasitology, Public Health |
| الوصف: | Background With visceral leishmaniasis (VL) incidence at its lowest level since the 1960s, increasing attention has turned to early detection and investigation of outbreaks. Methods Outbreak investigations were triggered by recognition of case clusters in the VL surveillance system established for the elimination program. Investigations included ascertainment of all VL cases by date of fever onset, household mapping and structured collection of risk factor data. Results VL outbreaks were investigated in 13 villages in 10 blocks of 7 districts. Data were collected for 20,670 individuals, of whom 272 were diagnosed with VL between 2012 and 2019. Risk was significantly higher among 10–19 year-olds and adults 35 or older compared to children younger than 10 years. Outbreak confirmation triggered vector control activities and heightened surveillance. VL cases strongly clustered in tolas (hamlets within villages) in which > 66% of residents self-identified as scheduled caste or scheduled tribe (SC/ST); 79.8% of VL cases occurred in SC/ST tolas whereas only 24.2% of the population resided in them. Other significant risk factors included being an unskilled non-agricultural laborer, migration for work in a brick kiln, living in a kuccha (mud brick) house, household crowding, habitually sleeping outside or on the ground, and open defecation. Conclusions Our data highlight the importance of sensitive surveillance with triggers for case cluster detection and rapid, careful outbreak investigations to better respond to ongoing and new transmission. The strong association with SC/ST tolas suggests that efforts should focus on enhanced surveillance in these disadvantaged communities. Graphical Abstract |
| وصف الملف: | application/pdf |
| تدمد: | 1756-3305 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::51455e4ee1009b59bccb4b76db07f372 https://doi.org/10.1186/s13071-020-04551-y |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....51455e4ee1009b59bccb4b76db07f372 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17563305 |
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