Abstract
There have been relatively few large-scale studies of spread of Post Kala-azar Dermal Leishmaniasis (PKDL) and factors that affects its prevalence. Consequently, little is known about the dynamics of PKDL, or the confounding factors that may give rise to its spread. A large-scale survey-based study of PKDL prevalence was conducted in the endemic region of Araria in Bihar, India. The results of the study indicate a sample prevalence of as high as 7.9 cases per 10,000 individuals. Socio-economic and demographical factors were recorded for each study participant, and the influence of these factors on PKDL and non-PKDL incidence in the sample populations was analysed. Our results suggest that factors of caste, cattle shed proximity, and gender all contribute to the characterization of the PKDL-afflicted population. The mean household size for PKDL households was found to be 4.9, almost doubled the number observed for non-PKDL households. Individuals in the age-group 10-19 years old, Hindus, or those belonging to Schedule Caste are more likely to get PKDL than others in the population. Consideration of these factors can provide a clear starting point for further in-depth examination of their contribution to PKDL patterns.
Highlights
Visceral leishmaniasis (VL) is a neglected potentially fatal disease transmitted by sand flies
Most of the estimated 200,000 to 400,000 annual new VL cases reported worldwide are located in India, with its state of Bihar accounting for 90% of cases [1]
Surveillance of Post Kala-azar Dermal Leishmaniasis (PKDL) is critical to elimination of VL, as PKDL cases may serve as reservoirs for the VL disease transmission during the inter-epidemic period
Summary
Visceral leishmaniasis (VL) is a neglected potentially fatal disease transmitted by sand flies. Most of the estimated 200,000 to 400,000 annual new VL cases reported worldwide are located in India, with its state of Bihar accounting for 90% of cases [1]. Government of India, with aid from World Health Organization in 2005 initiated programs to eliminate visceral leishmaniasis. With current reporting levels of VL cases (which are under estimated) it seems unlikely that 2015 goals will be achieved as objective of the VL elimination initiative is to reduce VL incidence below 1 per 10,000 per year at block level (i.e. just smaller administrative unit) within the district, but current incidence is around 20 per 10,000 per year at block level in many endemic regions. One of the objectives for reducing the annual incidence of VL is to reduce cases of PKDL to interrupt VL transmission [2]. There are currently no accurate information/data on specific characteristics and burden of PKDL
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