Abstract

BackgroundVisceral Leishmaniasis (VL) is a vector-borne infectious disease, caused by the protozoan Leishmania donovani, which is transmitted by phlebotomine sand flies. In an earlier study in Bihar, India, we found an association between incidence of VL and housing conditions. In the current study we investigated the influence of housing structure and conditions in and around the house on the indoor abundance of Phlebotomus argentipes, the vector of VL in this area.MethodsIn each of 50 study villages in Muzaffarpur district, we randomly selected 10 houses. Light traps were installed in each house for one night during three annual peaks of sand fly density over two successive years. Sand flies captured were morphologically identified and segregated by species, sex and feeding status. Data on housing conditions and socio-economic status were also collected. We fitted a linear mixed-effects regression model with log-transformed P. argentipes counts as outcome variable and village as random effect.Results P. argentipes was found in all but four of the 500 households. There was considerable variability between the years and the seasons. On bivariate analysis, housing structure, dampness of the floor, keeping animals inside, presence of animal dung around the house, and socio-economic status were all significantly associated with sand fly density. Highest sand fly densities were observed in thatched houses. In the multivariate model only the housing structure and socio-economic status remained significant.ConclusionsBetter housing conditions are associated with lower sand fly densities, independent of other socio-economic conditions. However, in this area in Bihar even in the better-built houses sand flies are present.

Highlights

  • Visceral Leishmaniasis (VL) or kala-azar is an infectious disease caused by the protozoan parasite Leishmania donovani, which is transmitted by phlebotomine sand flies

  • To further elucidate the influence of housing structure on sand fly density, we investigated the association between P. argentipes density and different types of housing as well as other conditions in and around the house, while controlling for potential confounding by socio-economic status

  • For the bivariate analysis we report coefficients with their p-values as well as median sand fly densities; for the final model we report the coefficients with their corresponding p-values and the mean P. argentipes densities predicted by the model for a village with average vector density

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Summary

Introduction

Visceral Leishmaniasis (VL) or kala-azar is an infectious disease caused by the protozoan parasite Leishmania donovani, which is transmitted by phlebotomine sand flies. Three VL endemic countries - India, Nepal and Bangladesh- have committed to eliminate VL from the region by 2015. Their target is to reduce the annual VL incidence to less than one new case per 10,000 inhabitants in all endemic districts [4]. In India, the National Kala-azar Elimination Program has adopted two main strategies: early detection and treatment of cases in VL endemic districts and vector control using indoor residual spraying (IRS) of houses and cattle sheds. Visceral Leishmaniasis (VL) is a vector-borne infectious disease, caused by the protozoan Leishmania donovani, which is transmitted by phlebotomine sand flies. In the current study we investigated the influence of housing structure and conditions in and around the house on the indoor abundance of Phlebotomus argentipes, the vector of VL in this area

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