ArticleParasites & vectors2021
Visceral leishmaniasis outbreaks in Bihar: community-level investigations in the context of elimination of kala-azar as a public health problem.
Article in Parasites & vectors, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Ethical reporting and oversight in outbreak investigations conducted in India, 2015-2025: a systematic review.BMC medical ethics · 2026Pooled it
- What can LMICs learn from transition of Bihar's disease surveillance reporting from paper to portal?Dialogues in health · 2026Article
- Insights into animal reservoir hosts for the circulation ofOne health (Amsterdam, Netherlands) · 2026Article
- High Seropositivity to rK39 and Capture of Leishmania-Infected Sand Flies in Bihar and Jharkhand Emphasize the Need for Post-Elimination Surveillance of Visceral Leishmaniasis in India.The Journal of infectious diseases · 2026Article
- Elimination of visceral leishmaniasis as a public health problem in Bangladesh: Lessons learned and questions remaining.PLoS neglected tropical diseases · 2026Review
- Targeting environmental determinants and settlements in public health planning for the containment of visceral leishmaniasis: a One Health perspective.Frontiers in public health · 2026Article
- Neglected by Design: Occupational Parasitic Infections in India's Lower Castes.The Yale journal of biology and medicine · 2025Review
- Long-term trends of visceral leishmaniasis incidence and mortality in India 1990-2019: an application of joinpoint and age-period-cohort analysis.BMC infectious diseases · 2025Article
- Association of Post Kala-Azar Dermal Leishmaniasis pathogenesis with prolonged sunlight (ultraviolet radiations) exposure in VL endemic population of Bihar.Scientific reports · 2025Article
- Kala-azar elimination in India: reflections on success and sustainability.International health · 2025Article
- Patient insights research exploring disease awareness, patient life experience, and current management of visceral leishmaniasis in Bihar, India.PLoS neglected tropical diseases · 2025Article
- Inferring the regional distribution of Visceral Leishmaniasis incidence from data at different spatial scales.Communications medicine · 2024Article
- Nationwide cross-sectional surveillance of Leishmania donovani in phlebotomine sand flies and its impact on national kala-azar elimination in India.Scientific reports · 2024Article
- Molecular surveillance of insecticide resistance in Phlebotomus argentipes targeted by indoor residual spraying for visceral leishmaniasis elimination in India.PLoS neglected tropical diseases · 2023Article
- A Composite Recombinant Salivary Proteins Biomarker for Phlebotomus argentipes Provides a Surveillance Tool Postelimination of Visceral Leishmaniasis in India.The Journal of infectious diseases · 2022Article
- Knowledge, Attitude, and Practices among HIV/Leishmaniasis Co-Infected Patients in Bihar, India.The American journal of tropical medicine and hygiene · 2022Article
- Optimizing Village-Level Targeting of Active Case Detection to Support Visceral Leishmaniasis Elimination in India.Frontiers in cellular and infection microbiology · 2021Article
- Towards a Sustainable Vector-Control Strategy in the Post Kala-Azar Elimination Era.Frontiers in cellular and infection microbiology · 2021Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWith visceral leishmaniasis (VL) incidence at its lowest level since the 1960s, increasing attention has turned to early detection and investigation of outbreaks.
methodsOutbreak investigations were triggered by recognition of case clusters in the VL surveillance system established for the elimination program. Investigations included ascertainment of all VL cases by date of fever onset, household mapping and structured collection of risk factor data.
resultsVL outbreaks were investigated in 13 villages in 10 blocks of 7 districts. Data were collected for 20,670 individuals, of whom 272 were diagnosed with VL between 2012 and 2019. Risk was significantly higher among 10-19 year-olds and adults 35 or older compared to children younger than 10 years. Outbreak confirmation triggered vector control activities and heightened surveillance. VL cases strongly clustered in tolas (hamlets within villages) in which > 66% of residents self-identified as scheduled caste or scheduled tribe (SC/ST); 79.8% of VL cases occurred in SC/ST tolas whereas only 24.2% of the population resided in them. Other significant risk factors included being an unskilled non-agricultural laborer, migration for work in a brick kiln, living in a kuccha (mud brick) house, household crowding, habitually sleeping outside or on the ground, and open defecation.
conclusionsOur data highlight the importance of sensitive surveillance with triggers for case cluster detection and rapid, careful outbreak investigations to better respond to ongoing and new transmission. The strong association with SC/ST tolas suggests that efforts should focus on enhanced surveillance in these disadvantaged communities.
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