Visceral Leishmaniasis Prevalence and Associated Risk Factors in the Saran District of Bihar, India, from 2009 to July of 2011

Diana Perry Genesis Laboratories, Inc., Wellington, Colorado; Boring Canal Road, Patna, India

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Kandice Dixon Genesis Laboratories, Inc., Wellington, Colorado; Boring Canal Road, Patna, India

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Rajesh Garlapati Genesis Laboratories, Inc., Wellington, Colorado; Boring Canal Road, Patna, India

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Alex Gendernalik Genesis Laboratories, Inc., Wellington, Colorado; Boring Canal Road, Patna, India

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David Poché Genesis Laboratories, Inc., Wellington, Colorado; Boring Canal Road, Patna, India

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Richard Poché Genesis Laboratories, Inc., Wellington, Colorado; Boring Canal Road, Patna, India

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India is one of three countries that account for an estimated 300,000 of 500,000 cases of visceral leishmaniasis (VL) occurring annually. Bihar State is the most affected area of India, with more than 90% of the cases. Surveys were conducted in two villages within the Saran district of Bihar, India, from 2009 to July of 2011 to assess risk factors associated with VL. Forty-five cases were identified, and individuals were given an oral survey. The results indicated that men contracted the disease more than women (58%), and cases over the age of 21 years accounted for 42% of the total VL cases. April to June showed the highest number of new cases. Of 135 households surveyed for sleeping conditions, 95% reported sleeping outside, and 98% slept in beds. Proximity to VL cases was the greatest risk factor (cluster 1 relative risk = 11.89 and cluster 2 relative risk = 138.34). The VL case clustering observed in this study can be incorporated in disease prevention strategies to more efficiently and effectively target VL control efforts.

Author Notes

* Address correspondence to Richard Poché, PO Box 1195, Wellington, CO 80549. E-mail: richard@genesislabs.com

Authors' addresses: Diana Perry, Kandice Dixon, Rajesh Garlapati, Alex Gendernalik, David Poché, and Richard Poché, Genesis Laboratories, Inc. NA, Wellington, CO, E-mails: diana@genesislabs.com, kandice@genesislabs.com, raj@genesislabs.com, alex@genesislabs.com, david@genesislabs.com, and richard@genesislabs.com.

  • 1.

    Desjeux P, 2001. The increase in risk factors for leishmaniasis worldwide. Trans R Soc Trop Med Hyg 95: 239243.

  • 2.

    Poché D, Garlapati R, Ingenloff K, Remmers J, Poché R, 2010. Bionomics of phlebotomine sand flies from three villages in Bihar, India. J Vector Ecol 36: 112.

  • 3.

    Bora D, 1999. Epidemiology of visceral leishmaniasis in India. Natl Med J India 12: 6268.

  • 4.

    Desjeux P, 2004. Leishmaniasis: current situation and new perspectives. CIMID 27: 305318.

  • 5.

    Bern C, Hightower AW, Chowdhury R, Ali M, Amann J, Wagatsuma Y, Haque R, Kurkjian K, Vaz LE, Begum M, Akter T, Cetre-Sossah CB, Ahluwalia IB, Dotson E, Secor WE, Breiman RF, Maguire J, 2005. Risk factors for kala-azar in Bangladesh. Emerg Infect Dis 11: 655662.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Ranjan A, Sur D, Singh VP, Siddigue NA, Manna B, Lal CS, Sinha PK, Kishore K, Bhattacharya SK, 2005. Risk factors for Indian kala-azar. Am J Trop Med Hyg 73: 7478.

  • 7.

    Singh SP, Reddy CSD, Rabindra NM, Sundar S, 2006. Knowledge, attitude, and practices related to kala-azar in rural areas of Bihar State, India. Am J Trop Med Hyg 75: 505508.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Dey A, Sharma M, Singh S, 2007. First case of indigenous visceral leishmaniasis from central India. Am J Trop Med Hyg 77: 9598.

  • 9.

    Choudhury N, Saxena NBL, 1987. Visceral leishmaniasis in India—a brief review. J Comm Dis 19: 332340.

  • 10.

    Kishore K, Kumar V, Kesari S, Dinesh DS, Kumar AJ, Das P, Bhattacharya SK, 2006. Vector control in leishmaniasis. Indian J Med Res 123: 467472.

  • 11.

    Killick-Kendrick R, 1999. The biology and control of phlebotomine sand flies. Clin Dermatol 17: 279289.

  • 12.

    World Health Organization (WHO), 2002. Urbanization: an increasing risk factor for leishmaniasis. Wkly Epidemiol Rec 77: 365372.

  • 13.

    Khanal B, Picado A, Bhattara NR, Van Der Auwera G, Das ML, Ostyn B, Davies CR, Boelaert M, Dujardin J, Rijal S, 2010. Spatial analysis of Leishmania donovani exposure in humans and domestic animals in a recent kala azar focus in Nepal. Parasitology 137: 15971603.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Desjeux P, 1996. Leishmaniasis. Public health aspects and control. Clin Dermatol 14: 417423.

  • 15.

    Claborn DM, 2010. The biology and control of leishmaniasis vectors. J Glob Infect Dis 2: 127134.

  • 16.

    Cerf BJ, Jones TC, Badaro R, Sampaio D, Teixeira R, Johnson WD, 1987. Malnutrition as a risk factor for severe visceral leishmaniasis. J Infect Dis 156: 10301033.

  • 17.

    Thakur CP, 2000. Socio-economics of visceral leishmaniasis in Bihar (India). Trans R Soc Trop Med Hyg 94: 156157.

  • 18.

    Rijal S, Uranw S, Chappuis F, Picado A, Khanal B, Paudel IS, Andersen EW, Meheus F, Ostyn B, Dasl ML, Davies C, Boelaert M, 2010. Epidemiology of Leishmania donovani infection inhigh-transmission foci in Nepal. Trop Med Int Health 15: 2128.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Singh SP, Hasker E, Picado A, Gidwani K, Malaviya P, Singh RP, Boelaert M, Sundar S, 2010. Risk factors for visceral leishmaniasis in India; further evidence on the role of domestic animals. Trop Med Int Health 15: 2935.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Boelaert M, Meheus F, Sanchez A, Singh SP, Vanlerberghe V, Picado A, Meessen B, Sundar S, 2009. The poorest of the poor: a poverty appraisal of households affected by visceral leishmaniasis in Bihar, India. Trop Med Int Health 14: 639644.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Harhay MO, Olliaro PL, Vaillant M, Chappuis F, Lima MA, Ritmeijer K, Costa CH, Costa DL, Rijal S, Sundar S, Balasegaram M, 2011. Who is a typical patient with visceral leishmaniasis? Characterizing the demographic and nutritional profile of patients in Brazil, East Africa, and South Asia. Am J Trop Med Hyg 84: 543550.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Bern C, Courtenay O, Alvar J, 2010. Of cattle, sand flies and men: a systematic review of risk factor analysis for South Asian visceral leishmaniasis and implications for elimination. PLoS Negl Trop Dis 4: 19.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Kumar R, Kumar P, Chowdhary RK, Pai K, Kumar K, Pandey HP, Singh VP, Sundar S, 1999. Kala-azar epidemic in Varanasi district, India. Bull World Health Organ 77: 371374.

  • 24.

    Rai R, Sehgal P, 1990. Kala-azar in Varanasi (U.P.): preliminary observations. J Commun Dis 22: 120123.

  • 25.

    Bern C, Joshi AB, Jha SN, Das ML, Hightower A, Thakur GD, Bista MB, 2000. Factors associated with visceral leishmaniasis in Nepal: bed-net use is strongly protective. Am J Trop Med 63: 184188.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Poché R, Garlapati R, Elnaiem D, Perry D, Poché D, 2012. The role of Palmyra palm trees (Borassus flabellifer) and sand fly distribution in northeastern India. J Vector Ecol 37: 148153.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Topno RK, Das V, Ranjan A, Pandey K, Singh D, Kumar N, Siddiqui NA, Singh VP, Kesari S, Kumar N, Bimal S, Kumar AJ, Meena C, Kumar R, Das P, 2010. Asymptomatic infection with visceral leishmaniasis in a disease-endemic area in Bihar, India. Am J Trop Med Hyg 83: 502506.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Ibrahim ME, Lambson B, Yousie AO, Deifalla NS, Alnaiem DA, Ismail A, Yousif H, Ghalib HW, Khalil EAG, Kadaro A, Barker DC, El Hassan AM, 1999. Kala-azar in a high transmission focus: an ethnic and geographic dimension. Am J Trop Med Hyg 61: 941944.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Sundar S, Rosenkaimer F, Murray HW, 1994. Successful treatment of refactory visceral leishmaniasis in India using antimony plus interferon-γ. J Infect Dis 170: 659662.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Kulldorff M; Information Management Services, Inc., 2009. SaTScanTM v9.0: Software for the Spatial and Space-Time Scan Statistics. Available at: http://www.satscan.org/. Accessed October 1, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
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