Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis
Visceral leishmaniasis (VL) is declining in India and the World Health Organization's (WHO) 2020 'elimination as a public health problem' target has nearly been achieved. Intensified combined interventions might help reach elimination, but their impact has not been assessed. WHO'...
| Main Authors: | , , , , , , , , , , |
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| Other Authors: | |
| Format: | Journal article |
| Language: | English |
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Elsevier
2022
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| _version_ | 1826307635688767488 |
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| author | Kumar, V Siddiqui, NA Pollington, TM Mandal, R Das, S Kesari, S Das, VR Pandey, K Hollingsworth, TD Chapman, LAC Das, P |
| author2 | Viboud, C |
| author_facet | Viboud, C Kumar, V Siddiqui, NA Pollington, TM Mandal, R Das, S Kesari, S Das, VR Pandey, K Hollingsworth, TD Chapman, LAC Das, P |
| author_sort | Kumar, V |
| collection | OXFORD |
| description | Visceral leishmaniasis (VL) is declining in India and the World Health Organization's (WHO) 2020 'elimination as a public health problem' target has nearly been achieved. Intensified combined interventions might help reach elimination, but their impact has not been assessed. WHO's Neglected Tropical Diseases 2021–2030 roadmap provides an opportunity to revisit VL control strategies.
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We estimated the combined effect of a district-wide pilot of intensified interventions in the highly-endemic Vaishali district, where cases fell from 3,598 in 2012–2014 to 762 in 2015–2017. The intensified control approach comprised indoor residual spraying with improved supervision; VL-specific training for accredited social health activists to reduce onset-to-diagnosis time; and increased Information Education & Communication activities in the community. We compared the rate of incidence decrease in Vaishali to other districts in Bihar state via an interrupted time series analysis with a spatiotemporal model informed by previous VL epidemiological estimates.
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Changes in Vaishali's rank among Bihar's endemic districts in terms of monthly incidence showed a change pre-pilot (3rd highest out of 33 reporting districts) vs. during the pilot (9th) (p<1e-10). The rate of decline in Vaishali's incidence saw no change in rank at 11th highest, both pre-pilot & during the pilot. Counterfactual model simulations suggest an estimated median of 354 cases (IQR 234–479) were averted by the Vaishali pilot between January 2015 and December 2017.
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Strengthening control strategies may have precipitated a substantial change in VL incidence in Vaishali and suggests this approach should be piloted in other highly-endemic districts. |
| first_indexed | 2024-03-07T07:06:07Z |
| format | Journal article |
| id | oxford-uuid:595f3700-3958-4de6-bfba-73afdd90b9f4 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:06:07Z |
| publishDate | 2022 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:595f3700-3958-4de6-bfba-73afdd90b9f42022-05-11T11:41:56ZImpact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:595f3700-3958-4de6-bfba-73afdd90b9f4EnglishSymplectic ElementsElsevier2022Kumar, VSiddiqui, NAPollington, TMMandal, RDas, SKesari, SDas, VRPandey, KHollingsworth, TDChapman, LACDas, PViboud, CVisceral leishmaniasis (VL) is declining in India and the World Health Organization's (WHO) 2020 'elimination as a public health problem' target has nearly been achieved. Intensified combined interventions might help reach elimination, but their impact has not been assessed. WHO's Neglected Tropical Diseases 2021–2030 roadmap provides an opportunity to revisit VL control strategies. <br><br> We estimated the combined effect of a district-wide pilot of intensified interventions in the highly-endemic Vaishali district, where cases fell from 3,598 in 2012–2014 to 762 in 2015–2017. The intensified control approach comprised indoor residual spraying with improved supervision; VL-specific training for accredited social health activists to reduce onset-to-diagnosis time; and increased Information Education & Communication activities in the community. We compared the rate of incidence decrease in Vaishali to other districts in Bihar state via an interrupted time series analysis with a spatiotemporal model informed by previous VL epidemiological estimates. <br><br> Changes in Vaishali's rank among Bihar's endemic districts in terms of monthly incidence showed a change pre-pilot (3rd highest out of 33 reporting districts) vs. during the pilot (9th) (p<1e-10). The rate of decline in Vaishali's incidence saw no change in rank at 11th highest, both pre-pilot & during the pilot. Counterfactual model simulations suggest an estimated median of 354 cases (IQR 234–479) were averted by the Vaishali pilot between January 2015 and December 2017. <br><br> Strengthening control strategies may have precipitated a substantial change in VL incidence in Vaishali and suggests this approach should be piloted in other highly-endemic districts. |
| spellingShingle | Kumar, V Siddiqui, NA Pollington, TM Mandal, R Das, S Kesari, S Das, VR Pandey, K Hollingsworth, TD Chapman, LAC Das, P Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis |
| title | Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis |
| title_full | Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis |
| title_fullStr | Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis |
| title_full_unstemmed | Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis |
| title_short | Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis |
| title_sort | impact of intensified control on visceral leishmaniasis in a highly endemic district of bihar india an interrupted time series analysis |
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