Visceral leishmaniasis eradication is a reality: Data from a community-based active Surveillance in Bangladesh

Abstract

More than 20 million people in Bangladesh are considered at risk of developing visceral leishmaniasis(VL). A community-based active surveillance was conducted in eight randomly selected villages in a highlyendemic area of Bangladesh from 2006 to 2008. A total of 6,761 individuals living in 1,550 mud-walled houseswere included in the active surveillance. Rapid rK39 dipstick tests were conducted throughout the study period tofacilitate the case diagnosis. Individuals with previous or current clinical leishmaniasis were identified on the basisof the case definition of the VL elimination program. Untreated cases of suspected VL were referred to the hospitalfor treatment. Socioeconomic and environmental information including bed net use was also collected. In 2006,the annual incidence of clinical leishmaniasis in the study area was 141.9 cases per 10,000 population, which wassignificantly increased by the following year owing to community-based active surveillance for case detection andreporting. However, early case detection and early referral for treatment led to a significant decrease in incidencein 2008. This study suggests that community-based active surveillance using a simple diagnostic tool might playa role in achieving the goal of the VL elimination program. Copyright © 2012 by The Japanese Society of Tropical Medicine.