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. 2011 Mar 4;6(3):e14751.
doi: 10.1371/journal.pone.0014751.

Visceral leishmaniasis in Muzaffarpur district, Bihar, India from 1990 to 2008

Paritosh Malaviya  1 , Albert Picado, Shri Prakash Singh, Epco Hasker, Rudra Pratap Singh, Marleen Boelaert, Shyam Sundar
Affiliations

Visceral leishmaniasis in Muzaffarpur district, Bihar, India from 1990 to 2008

Paritosh Malaviya et al. PLoS One. .

Abstract

Background: Visceral Leishmaniasis (VL) is a vector-borne disease transmitted by Phlebotomus argentipes. To understand the VL seasonality, annual and monthly variations of VL incidence and its relationship to meteorological variables, the numbers of VL cases reported in Muzaffarpur district, Bihar, India from 1990 to 2008 were studied.

Methods: Annual VL incidence per 10,000 and the total number of annual VL cases reported at block Community Health Centres (CHC), Public Hospitals or Non-Governmental Organisations (NGO) and the number of VL cases per month from 2000 to 2008 as well as the monthly average of cases for 2000-08, 2000-04 and 2005-08 periods along with the monthly averages of temperature, rainfall and relative humidity were plotted. VL Standardised Incidence Ratios per block were computed for the periods of 1990-1993, 1994-1998, 1999-2004 and 2005-2008 and month wise from 2002 to 2008. A negative binomial regression model was used to evaluate the association between meteorological variables and the number of VL cases per month from 2000 to 2008.

Results: A total of 68,358 VL cases were reported in Muzaffarpur district from 1990 to 2008, ranging from 1,2481 in 1992 to 1,161 in 2001. The blocks with the highest number of cases shifted from East (1990-98) to West (1999-2008). Monthly averages of cases ranged from 149 to 309, highest peak in March-April and another one in July. Monthly VL incidence was associated positively to rainfall and negatively to relative humidity and the numbers of VL cases in the previous month.

Interpretation: The number of cases reported to the public health sector allowed the describing of the spatial distribution and temporal variations in the Muzaffarpur from 1990 to 2008. However, to assess the actual VL burden, as well as the efficacy of the control measures applied in the district, reporting from private practices and NGOs should be encouraged.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The total numbers of Visceral Leishmaniasis (VL) cases reported in Muzaffapur district per year from 1990 to 2008.
The proportion of cases reported to the different health care facilities: Community Health Centre (CHC), Public Hospitals or Non-Governmental Organisation (NGO) is represented as percentage of the total cases per year inside boxes of different colours. The annual VL incidence rate (per 10,000) in Muzaffarpur district is noted at top of the figure.
Figure 2
Figure 2. Observed and predicted VL cases and recorded meteorological parameters for each month from 2000 to 2008.
(A) The observed (solid red line) and the predicted (dashed line – estimated from the negative binomial model) numbers of monthly Visceral Leishmaniasis (VL) cases in Muzaffarpur district from 2000 to 2008. (B) Monthly rainfall in mm (blue histogram), average temperature (temp) in °C (solid red line) and average relative humidity (RH) in % (dashed green line).
Figure 3
Figure 3. Seasonality of VL cases in the two phases (2000–04 and 2005–08) identified during the study period.
(A) The observed average number of monthly Visceral Leishmaniasis (VL) cases in Muzaffarpur district: from 2000 to 2008 (solid red line), 2000 to 2004 (dotted blue line) and 2005 to 2008 (green line). Predicted average of monthly VL cases from 2000 to 2008 (estimated from the negative binomial model) plotted as black dotted line. (B) Monthly average rainfall in mm (blue histogram), temperature (temp) in °C (red line) and relative humidity (RH) in % (dashed green line).
Figure 4
Figure 4. Visceral Leishmaniasis (VL) Standardised Incidence Ratio (SIR) per block in Muzaffarpur district in Bihar, India.
VL SIR computed for the following periods: 1990–1993, 1994–1998, 1999–2004 and 2005–2008 using the VL incidence per period in all blocks as reference.
Figure 5
Figure 5. Visceral Leishmaniasis (VL) Standardised Incidence Ratio (SIR) per block and month in Muzzafarpur district in Bihar, India from 2002 to 2008.
SIR was calculated per month using the VL incidence per month in all blocks as reference.
See this image and copyright information in PMC

References

    1. Desjeux P. Leishmaniasis: current situation and new perspectives. Comparative Immunology, Microbiology and Infectious Diseases. 2004;27(5):305–18. - PubMed
    1. Murray HW, Berman JD, Davies CR, Saravia NG. Advances in leishmaniasis. Lancet. 2005;366(9496):1561–77. - PubMed
    1. Joshi A, Narain JP, Prasittisuk C, Bhatia R, Hashim G, et al. Can visceral leishmaniasis be eliminated from Asia? J Vector Borne Dis. 2008;45(2):105–11. - PubMed
    1. Bhattacharya SK, Sur D, Sinha PK, Karbwang J. Elimination of leishmaniasis (kala-azar) from the Indian subcontinent is technically feasible & operationally achievable. Indian J Med Res. 2006;123(3):195–6. - PubMed
    1. Hasker E, Singh SP, Malaviya P, Singh RP, Shankar R, et al. Management of visceral leishmaniasis in rural primary health care services in Bihar, India. Trop Med Int Health. 2010;15:55–62. - PMC - PubMed

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