Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.

<h4>Background</h4>In 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with ind...

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Main Authors: Rinki Deb, Rudra Pratap Singh, Prabhas Kumar Mishra, Lisa Hitchins, Emma Reid, Arti Manorama Barwa, Debanjan Patra, Chandrima Das, Indranil Sukla, Ashish Kumar Srivastava, Shilpa Raj, Swikruti Mishra, Madhuri Swain, Swapna Mondal, Udita Mandal, Geraldine M Foster, Anna Trett, Gala Garrod, Laura McKenzie, Asgar Ali, Karthick Morchan, Indrajit Chaudhuri, Nupur Roy, Naresh K Gill, Chandramani Singh, Neeraj Agarwal, Sadhana Sharma, Michelle C Stanton, Janet Hemingway, Sridhar Srikantiah, Michael Coleman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-08-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0009101
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author Rinki Deb
Rudra Pratap Singh
Prabhas Kumar Mishra
Lisa Hitchins
Emma Reid
Arti Manorama Barwa
Debanjan Patra
Chandrima Das
Indranil Sukla
Ashish Kumar Srivastava
Shilpa Raj
Swikruti Mishra
Madhuri Swain
Swapna Mondal
Udita Mandal
Geraldine M Foster
Anna Trett
Gala Garrod
Laura McKenzie
Asgar Ali
Karthick Morchan
Indrajit Chaudhuri
Nupur Roy
Naresh K Gill
Chandramani Singh
Neeraj Agarwal
Sadhana Sharma
Michelle C Stanton
Janet Hemingway
Sridhar Srikantiah
Michael Coleman
author_facet Rinki Deb
Rudra Pratap Singh
Prabhas Kumar Mishra
Lisa Hitchins
Emma Reid
Arti Manorama Barwa
Debanjan Patra
Chandrima Das
Indranil Sukla
Ashish Kumar Srivastava
Shilpa Raj
Swikruti Mishra
Madhuri Swain
Swapna Mondal
Udita Mandal
Geraldine M Foster
Anna Trett
Gala Garrod
Laura McKenzie
Asgar Ali
Karthick Morchan
Indrajit Chaudhuri
Nupur Roy
Naresh K Gill
Chandramani Singh
Neeraj Agarwal
Sadhana Sharma
Michelle C Stanton
Janet Hemingway
Sridhar Srikantiah
Michael Coleman
author_sort Rinki Deb
collection DOAJ
description <h4>Background</h4>In 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with indoor residual spraying (IRS) of insecticide. Initially, India applied DDT with stirrup pumps for IRS, however, this did not reduce transmission. After 2015 onwards, the pyrethroid alpha-cypermethrin was applied with compression pumps, and entomological surveillance was initiated in 2016.<h4>Methods</h4>Eight sentinel sites were established in the Indian states of Bihar, Jharkhand and West Bengal. IRS coverage was monitored by household survey, quality of insecticide application was measured by HPLC, presence and abundance of the VL vector was monitored by CDC light traps, insecticide resistance was measured with WHO diagnostic assays and case incidence was determined from the VL case register KAMIS.<h4>Results</h4>Complete treatment of houses with IRS increased across all sites from 57% in 2016 to 70% of houses in 2019, rising to >80% if partial house IRS coverage is included (except West Bengal). The quality of insecticide application has improved compared to previous studies, average doses of insecticide on filters papers ranged from 1.52 times the target dose of 25mg/m2 alpha-cypermethrin in 2019 to 1.67 times in 2018. Resistance to DDT has continued to increase, but the vector was not resistant to carbamates, organophosphates or pyrethroids. The annual and seasonal abundance of P. argentipes declined between 2016 to 2019 with an overall infection rate of 0.03%. This was associated with a decline in VL incidence for the blocks represented by the sentinel sites from 1.16 per 10,000 population in 2016 to 0.51 per 10,000 in 2019.<h4>Conclusion</h4>Through effective case detection and management reducing the infection reservoirs for P. argentipes in the human population combined with IRS keeping P. argentipes abundance and infectivity low has reduced VL transmission. This combination of effective case management and vector control has now brought India within reach of the VL elimination targets.
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spelling doaj.art-fb987c55de684048a8e903c8561dba232022-12-21T21:34:25ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-08-01158e000910110.1371/journal.pntd.0009101Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.Rinki DebRudra Pratap SinghPrabhas Kumar MishraLisa HitchinsEmma ReidArti Manorama BarwaDebanjan PatraChandrima DasIndranil SuklaAshish Kumar SrivastavaShilpa RajSwikruti MishraMadhuri SwainSwapna MondalUdita MandalGeraldine M FosterAnna TrettGala GarrodLaura McKenzieAsgar AliKarthick MorchanIndrajit ChaudhuriNupur RoyNaresh K GillChandramani SinghNeeraj AgarwalSadhana SharmaMichelle C StantonJanet HemingwaySridhar SrikantiahMichael Coleman<h4>Background</h4>In 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with indoor residual spraying (IRS) of insecticide. Initially, India applied DDT with stirrup pumps for IRS, however, this did not reduce transmission. After 2015 onwards, the pyrethroid alpha-cypermethrin was applied with compression pumps, and entomological surveillance was initiated in 2016.<h4>Methods</h4>Eight sentinel sites were established in the Indian states of Bihar, Jharkhand and West Bengal. IRS coverage was monitored by household survey, quality of insecticide application was measured by HPLC, presence and abundance of the VL vector was monitored by CDC light traps, insecticide resistance was measured with WHO diagnostic assays and case incidence was determined from the VL case register KAMIS.<h4>Results</h4>Complete treatment of houses with IRS increased across all sites from 57% in 2016 to 70% of houses in 2019, rising to >80% if partial house IRS coverage is included (except West Bengal). The quality of insecticide application has improved compared to previous studies, average doses of insecticide on filters papers ranged from 1.52 times the target dose of 25mg/m2 alpha-cypermethrin in 2019 to 1.67 times in 2018. Resistance to DDT has continued to increase, but the vector was not resistant to carbamates, organophosphates or pyrethroids. The annual and seasonal abundance of P. argentipes declined between 2016 to 2019 with an overall infection rate of 0.03%. This was associated with a decline in VL incidence for the blocks represented by the sentinel sites from 1.16 per 10,000 population in 2016 to 0.51 per 10,000 in 2019.<h4>Conclusion</h4>Through effective case detection and management reducing the infection reservoirs for P. argentipes in the human population combined with IRS keeping P. argentipes abundance and infectivity low has reduced VL transmission. This combination of effective case management and vector control has now brought India within reach of the VL elimination targets.https://doi.org/10.1371/journal.pntd.0009101
spellingShingle Rinki Deb
Rudra Pratap Singh
Prabhas Kumar Mishra
Lisa Hitchins
Emma Reid
Arti Manorama Barwa
Debanjan Patra
Chandrima Das
Indranil Sukla
Ashish Kumar Srivastava
Shilpa Raj
Swikruti Mishra
Madhuri Swain
Swapna Mondal
Udita Mandal
Geraldine M Foster
Anna Trett
Gala Garrod
Laura McKenzie
Asgar Ali
Karthick Morchan
Indrajit Chaudhuri
Nupur Roy
Naresh K Gill
Chandramani Singh
Neeraj Agarwal
Sadhana Sharma
Michelle C Stanton
Janet Hemingway
Sridhar Srikantiah
Michael Coleman
Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
PLoS Neglected Tropical Diseases
title Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
title_full Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
title_fullStr Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
title_full_unstemmed Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
title_short Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
title_sort impact of irs four years of entomological surveillance of the indian visceral leishmaniases elimination programme
url https://doi.org/10.1371/journal.pntd.0009101
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