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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Elimination of visceral leishmaniasis in the Indian subcontinent
T2 - a comparison of predictions from three transmission models
AU - Le Rutte, Epke A.
AU - Chapman, Lloyd A.C.
AU - Coffeng, Luc E.
AU - Jervis, Sarah
AU - Hasker, Epco C.
AU - Dwivedi, Shweta
AU - Karthick, Morchan
AU - Das, Aritra
AU - Mahapatra, Tanmay
AU - Chaudhuri, Indrajit
AU - Boelaert, Marleen C.
AU - Medley, Graham F.
AU - Srikantiah, Sridhar
AU - Hollingsworth, T. Deirdre
AU - de Vlas, Sake J.
N1 - Publisher Copyright: © 2017 The Authors
PY - 2017/3/1
Y1 - 2017/3/1
N2 - We present three transmission models of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) with structural differences regarding the disease stage that provides the main contribution to transmission, including models with a prominent role of asymptomatic infection, and fit them to recent case data from 8 endemic districts in Bihar, India. Following a geographical cross-validation of the models, we compare their predictions for achieving the WHO VL elimination targets with ongoing treatment and vector control strategies. All the transmission models suggest that the WHO elimination target (<1 new VL case per 10,000 capita per year at sub-district level) is likely to be met in Bihar, India, before or close to 2020 in sub-districts with a pre-control incidence of 10 VL cases per 10,000 people per year or less, when current intervention levels (60% coverage of indoor residual spraying (IRS) of insecticide and a delay of 40 days from onset of symptoms to treatment (OT)) are maintained, given the accuracy and generalizability of the existing data regarding incidence and IRS coverage. In settings with a pre-control endemicity level of 5/10,000, increasing the effective IRS coverage from 60 to 80% is predicted to lead to elimination of VL 1–3 years earlier (depending on the particular model), and decreasing OT from 40 to 20 days to bring elimination forward by approximately 1 year. However, in all instances the models suggest that L. donovani transmission will continue after 2020 and thus that surveillance and control measures need to remain in place until the longer-term aim of breaking transmission is achieved.
AB - We present three transmission models of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) with structural differences regarding the disease stage that provides the main contribution to transmission, including models with a prominent role of asymptomatic infection, and fit them to recent case data from 8 endemic districts in Bihar, India. Following a geographical cross-validation of the models, we compare their predictions for achieving the WHO VL elimination targets with ongoing treatment and vector control strategies. All the transmission models suggest that the WHO elimination target (<1 new VL case per 10,000 capita per year at sub-district level) is likely to be met in Bihar, India, before or close to 2020 in sub-districts with a pre-control incidence of 10 VL cases per 10,000 people per year or less, when current intervention levels (60% coverage of indoor residual spraying (IRS) of insecticide and a delay of 40 days from onset of symptoms to treatment (OT)) are maintained, given the accuracy and generalizability of the existing data regarding incidence and IRS coverage. In settings with a pre-control endemicity level of 5/10,000, increasing the effective IRS coverage from 60 to 80% is predicted to lead to elimination of VL 1–3 years earlier (depending on the particular model), and decreasing OT from 40 to 20 days to bring elimination forward by approximately 1 year. However, in all instances the models suggest that L. donovani transmission will continue after 2020 and thus that surveillance and control measures need to remain in place until the longer-term aim of breaking transmission is achieved.
KW - Detection and treatment
KW - Elimination
KW - Indian subcontinent
KW - Indoor residual spraying
KW - Kala-azar
KW - Mathematical modelling
KW - Neglected tropical disease
KW - Predictions
KW - Sandfly
KW - Transmission dynamics
KW - Visceral leishmaniasis
U2 - 10.1016/j.epidem.2017.01.002
DO - 10.1016/j.epidem.2017.01.002
M3 - Journal article
C2 - 28279458
AN - SCOPUS:85014485048
VL - 18
SP - 67
EP - 80
JO - Epidemics
JF - Epidemics
SN - 1755-4365
ER -