Skip to content Skip to navigation
University of Warwick
  • Study
  • |
  • Research
  • |
  • Business
  • |
  • Alumni
  • |
  • News
  • |
  • About

University of Warwick
Publications service & WRAP

Highlight your research

  • WRAP
    • Home
    • Search WRAP
    • Browse by Warwick Author
    • Browse WRAP by Year
    • Browse WRAP by Subject
    • Browse WRAP by Department
    • Browse WRAP by Funder
    • Browse Theses by Department
  • Publications Service
    • Home
    • Search Publications Service
    • Browse by Warwick Author
    • Browse Publications service by Year
    • Browse Publications service by Subject
    • Browse Publications service by Department
    • Browse Publications service by Funder
  • Help & Advice
University of Warwick

The Library

  • Login
  • Admin

Variations in visceral leishmaniasis burden, mortality and the pathway to care within Bihar, India

Tools
- Tools
+ Tools

Jervis, Sarah, Chapman, Lloyd A. C., Dwivedi, Shweta, Karthick, Morchan, Das, Aritra, Le Rutte, Epke A., Courtenay, Orin, Medley, Graham, Banerjee, Indranath, Mahapatra, Tanmay, Chaudhuri, Indrajit, Srikantiah, Sridhar and Hollingsworth, T. Déirdre (2017) Variations in visceral leishmaniasis burden, mortality and the pathway to care within Bihar, India. Parasites & Vectors, 10 (1). 601. doi:10.1186/s13071-017-2530-9

[img]
Preview
PDF
WRAP-variations-visceral-leishmaniasis-burden-mortality-pathway-care-Bihar-India-Chapman-2018.pdf - Published Version - Requires a PDF viewer.
Available under License Creative Commons Attribution 4.0.

Download (3072Kb) | Preview
[img] Archive (ZIP)
Additional-files-2017.zip - Supplemental Material

Download (1377Kb)
Official URL: http://dx.doi.org/10.1186/s13071-017-2530-9

Request Changes to record.

Abstract

Background

Visceral leishmaniasis (VL) has been targeted by the WHO for elimination as a public health problem (< 1 case/10,000 people/year) in the Indian sub-continent (ISC) by 2020. Bihar State in India, which accounts for the majority of cases in the ISC, remains a major target for this elimination effort. However, there is considerable spatial, temporal and sub-population variation in occurrence of the disease and the pathway to care, which is largely unexplored and a threat to achieving the target.

Methods

Data from 6081 suspected VL patients who reported being clinically diagnosed during 2012–2013 across eight districts in Bihar were analysed. Graphical comparisons and Chi-square tests were used to determine differences in the burden of identified cases by season, district, age and sex. Log-linear regression models were fitted to onset (of symptoms)-to-diagnosis and onset-to-treatment waiting times to estimate their associations with age, sex, district and various socio-economic factors (SEFs). Logistic regression models were used to identify factors associated with mortality.

Results

Comparisons of VL caseloads suggested an annual cycle peaking in January-March. A 17-fold variation in the burden of identified cases across districts and under-representation of young children (0–5 years) relative to age-specific populations in Bihar were observed. Women accounted for a significantly lower proportion of the reported cases than men (41 vs 59%, P < 0.0001). Age, district of residence, house wall materials, caste, treatment cost, travelling for diagnosis and the number of treatments for symptoms before diagnosis were identified as correlates of waiting times. Mortality was associated with age, district of residence, onset-to-treatment waiting time, treatment duration, cattle ownership and cost of diagnosis.

Conclusions

The distribution of VL in Bihar is highly heterogeneous, and reported caseloads and associated mortality vary significantly across different districts, posing different challenges to the elimination campaign. Socio-economic factors are important correlates of these differences, suggesting that elimination will require tailoring to population and sub-population circumstances.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Science > Life Sciences (2010- )
Library of Congress Subject Headings (LCSH): Leishmaniasis -- Treatment -- Bihar (India) , Leishmaniasis -- Prevention -- Bihar (India)
Journal or Publication Title: Parasites & Vectors
Publisher: BioMed Central Ltd.
ISSN: 1756-3305
Official Date: 7 December 2017
Dates:
DateEvent
7 December 2017Published
12 November 2017Accepted
Volume: 10
Number: 1
Article Number: 601
DOI: 10.1186/s13071-017-2530-9
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
NTD Modelling ConsortiumBill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
OPP1016872CAREBill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
Related URLs:
  • Related dataset

Request changes or add full text files to a record

Repository staff actions (login required)

View Item View Item

Downloads

Downloads per month over past year

View more statistics

twitter

Email us: wrap@warwick.ac.uk
Contact Details
About Us