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Elimination of visceral leishmaniasis in the Indian subcontinent : a comparison of predictions from three transmission models

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Le Rutte, Epke A., Chapman, Lloyd A. C., Coffeng, Luc E., Jervis, Sarah, Hasker, Epco C., Dwivedi, Shweta, Karthick, Morchan, Das, Aritra, Mahapatra, Tanmay, Chaudhuri, Indrajit, Boelaert, Marleen C., Medley, Graham F., Srikantiah, Sridhar, Hollingsworth, T. Déirdre and de Vlas, Sake J. (2017) Elimination of visceral leishmaniasis in the Indian subcontinent : a comparison of predictions from three transmission models. Epidemics, 18 . pp. 67-80. doi:10.1016/j.epidem.2017.01.002 ISSN 1755-4365.

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Official URL: http://dx.doi.org/10.1016/j.epidem.2017.01.002

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Abstract

We present three transmission models of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) with structural differences regarding the disease stage that provides the main contribution to transmission, including models with a prominent role of asymptomatic infection, and fit them to recent case data from 8 endemic districts in Bihar, India. Following a geographical cross-validation of the models, we compare their predictions for achieving the WHO VL elimination targets with ongoing treatment and vector control strategies. All the transmission models suggest that the WHO elimination target (<1 new VL case per 10,000 capita per year at sub-district level) is likely to be met in Bihar, India, before or close to 2020 in sub-districts with a pre-control incidence of 10 VL cases per 10,000 people per year or less, when current intervention levels (60% coverage of indoor residual spraying (IRS) of insecticide and a delay of 40 days from onset of symptoms to treatment (OT)) are maintained, given the accuracy and generalizability of the existing data regarding incidence and IRS coverage. In settings with a pre-control endemicity level of 5/10,000, increasing the effective IRS coverage from 60 to 80% is predicted to lead to elimination of VL 1–3 years earlier (depending on the particular model), and decreasing OT from 40 to 20 days to bring elimination forward by approximately 1 year. However, in all instances the models suggest that L. donovani transmission will continue after 2020 and thus that surveillance and control measures need to remain in place until the longer-term aim of breaking transmission is achieved.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH): Kala-azar -- Prevention -- Bihar (India), Kala-azar -- Transmission -- Bihar (India)
Journal or Publication Title: Epidemics
Publisher: Elsevier BV
ISSN: 1755-4365
Official Date: March 2017
Dates:
DateEvent
March 2017Published
6 March 2017Available
7 January 2017Accepted
21 December 2016Submitted
Volume: 18
Page Range: pp. 67-80
DOI: 10.1016/j.epidem.2017.01.002
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 9 March 2017
Date of first compliant Open Access: 9 March 2017
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
OPP1053230Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
NCODEV/Project 015374Sixth Framework Programmehttp://dx.doi.org/10.13039/100011103
RFA-AI-06-006National Institutes of Healthhttp://dx.doi.org/10.13039/100000002
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