Abstract
IntroductionIn 2005, Bangladesh, India, and Nepal joined forces to eliminate Visceral Leishmaniasis (or kala-azar) from the region by 2015. In Bangladesh the elimination target is set at less than one new case per 10,000 population per year at upazila (sub-district) level. As the deadline approaches, we review the status of the elimination initiative in this country.MethodsWe collected all available disease surveillance data at the Disease Control Unit of the Directorate General of Health Services, Government of Bangladesh from 1994 to 2013. Additionally, we retrieved data from the Civil Surgeon Office from the Mymensingh district, one of the most heavily affected areas in Bangladesh.ResultsBetween 1994 and 2013, 109,266 kala-azar cases causing 329 deaths were reported from 37 endemic districts in Bangladesh. Only 16 districts reported cases every year. The Mymensingh district was the most affected with 53,582 (49.04%) cases. Between 2008 and 2013 only 16 upazilas showed incidence rates above the elimination target in which they ranged from 1.06 to 18.25 per 10,000 people per year.DiscussionWhile clear progress has been made towards eliminating VL, 16 upazilas in Bangladesh had not yet reached the target in 2013, based on official notification data that probably suffered from under-reporting bias. The elimination initiative urgently needs to establish methods to ascertain and monitor the elimination target.
Highlights
In 2005, Bangladesh, India, and Nepal joined forces to eliminate Visceral Leishmaniasis from the region by 2015
While clear progress has been made towards eliminating Visceral Leishmaniasis (VL), 16 upazilas in Bangladesh had not yet reached the target in 2013, based on official notification data that probably suffered from under-reporting bias
Since the 1980s, after the interruption of DDT spraying, there has been a dramatic resurgence of VL, with 73,467 cases reported from Bangladesh between 1994 and 2004, and many more reported in India [3]
Summary
In 2005, Bangladesh, India, and Nepal joined forces to eliminate Visceral Leishmaniasis (or kala-azar) from the region by 2015. In Bangladesh the elimination target is set at less than one new case per 10,000 population per year at upazila (sub-district) level. Kala-azar became endemic in the region and spread slowly through Bengal, where it devastated the population of Burdwan and other areas. Between 1892 and 1898, one-third of the population of the Nowgong district in Assam, India died [4]. Another epidemic of VL in conjunction with the Spanish Influenza epidemic claimed a further 200,000 lives in Assam and in the Brahmaputra valley between 1918 and 1923 [5]. Since the 1980s, after the interruption of DDT spraying, there has been a dramatic resurgence of VL, with 73,467 cases reported from Bangladesh between 1994 and 2004, and many more reported in India [3]
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