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Active and passive case detection strategies for the control of leishmaniasis in Bangladesh | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Active and passive case detection strategies for the control of leishmaniasis in Bangladesh

Das AK, Harries AD, Hinderaker SG, Zachariah R, Ahmed BN, Shah GN, Khogali MA, Das GI, Ahmed EM, Ritmeijer KKD
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Abstract
SETTING
Two subdistricts in Bangladesh, Fulbaria and Trishal, which are hyperendemic for leishmaniasis.

OBJECTIVE
To determine 1) the numbers of patients diagnosed with visceral leishmaniasis (VL) and post-kala azar dermal leishmaniasis (PKDL) using an active case detection (ACD) strategy in Fulbaria and a passive case detection (PCD) strategy in Trishal, and 2) the time taken from symptoms to diagnosis in the ACD subdistrict.

DESIGN
A cross-sectional descriptive study of patients diagnosed from May 2010 to December 2011. The ACD strategy involved community education and outreach workers targeting households of index patients using symptom-based screening and rK-39 tests for suspected cases.

RESULTS
In the ACD subdistrict (Fulbaria) and PCD sub-district (Trishal), respectively 1088 and 756 residents were diagnosed with VL and 1145 and 37 with PKDL. In the ACD subdistrict, the median time to diagnosis for patients directly referred by outreach workers or self-referred was similar, at 60 days for VL and respectively 345 and 360 days for PKDL.

CONCLUSION
An ACD strategy at the subdistrict level resulted in an increased yield of VL and a much higher yield of PKDL. As PKDL acts as a reservoir for infection, a strategy of ACD and treatment can contribute to the regional elimination of leishmaniasis in the Indian sub-continent.

Countries

Bangladesh

Subject Area

neglected tropical diseaseskala azarfilovirus

Languages

English
DOI
10.5588/pha.13.0084
Published Date
21 Mar 2014
PubMed ID
26423756
Journal
Public Health Action
Volume | Issue | Pages
Volume 4, Issue 1, Pages 15-21
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