Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis.

Autor:	Kumar V; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India., Siddiqui NA; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India., Pollington TM; MathSys - Mathematics for Real-World Systems Centre for Doctoral Training, University of Warwick, Coventry CV4 7AL, UK; Big Data Institute (BDI), University of Oxford, Oxford OX3 7LF, UK; Centre for Tropical Medicine and Global Health, University of Oxford, Oxford OX3 7LG, UK; Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok 10400, Thailand., Mandal R; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India., Das S; All India Institute of Medical Sciences (AIIMS), Patna 801507, India., Kesari S; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India., Das VR; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India., Pandey K; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India., Hollingsworth TD; Big Data Institute (BDI), University of Oxford, Oxford OX3 7LF, UK., Chapman LAC; Centre for Mathematical Modelling of Infectious Diseases (CMMID), London School of Hygiene & Tropical Medicine (LSHTM), London WC1H 9SH, UK., Das P; Rajendra Memorial Research Institute of Medical Sciences (RMRIMS) (ICMR), Patna 800007, India; National Institute of Cholera and Enteric Diseases (NICED) (ICMR), Kolkata 700010, India. Electronic address: drpradeep.das@gmail.com.
Jazyk:	angličtina
Zdroj:	Epidemics [Epidemics] 2022 Jun; Vol. 39, pp. 100562. Date of Electronic Publication: 2022 Apr 21.
DOI:	10.1016/j.epidem.2022.100562
Abstrakt:	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. 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. 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 352 cases (IQR 234-477) were averted by the Vaishali pilot between January 2015 and December 2017, which was robust to modest changes in the onset-to-diagnosis distribution. 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. (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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