Human antibody reaction against recombinant salivary proteins of Phlebotomus orientalis in Eastern Africa
Study that aimed at uncovering valid markers of human exposure to vector sanfly P. orientalis order to help monitor the distribution of the VL vector and shape anti-vector interventions. The researchers "screened for anti-P. orientalis antibody responses in serum samples from individuals residing in Sudan and Ethiopia".
Integrating Case Detection of Visceral Leishmaniasis and Other Febrile Illness with Vector Control in the Post-Elimination Phase in Nepal
Following the completion of the attack phase of visceral leishmaniasis elimination Nepal is now entering the the consolidation and maintenance phases.This study evaluated different ACD approaches and vector control methods in Nepal. It highlights fever camps and insecticidal wall paint as potential sustainable strategies in the VL post-elimination program.
Amphotericin B deoxycholate for relapse visceral leishmaniasis in Bangladesh: a cross-sectional study
Cross-sectional study on 34 VL relapse patients reviewing the cure rate and adverse effects to amphotericin B deoxycholate in Bangladesh. The study supports the use of amphotericin B deoxycholate as a second line drug for visceral leishmaniasis in Bangladesh.
Visceral leishmaniasis: Spatiotemporal heterogeneity and drivers underlying the hotspots in Muzaffarpur, Bihar, India
Using multiple geospatial and spatiotemporal analyses on data from 2007 to 2015, this study identifes hotspots of VL in the Muzzarfapur district in the endemic state of Bihar in India, from 2007 to 2015. It demonstrates clear spatiotemporal heterogeneity of VL in the area with hotspots occurring almost always in the poorest communities.
The study also aimed at investigating potential drivers of hotspots and identify the potential role of waning immunity. The authors add that "to further understand the drivers and transmission dynamics underlying VL hotspots, and ultimately inform policy, additional longitudinal data are needed to understand more about the role of asymptomatic infections, human movement, sand fly distribution and immunity."
WHO bi-regional consultation on the status of implementation of leishmaniasis control strategies and epidemiological situations in Eastern Africa 2018
KalaCORE partners working on VL elimination in Bangladesh, Nepal and India met during the International Conference on Innovations for the Elimination and Control of Visceral Leishmaniasis (IEC-VL) 28-30 November 2018, in New Delhi, India.
Partners and presenters have kindly shared their presentations, listed below:
(To download, please click on the title of this article)
- ‘Tackling Visceral Leishmaniasis in Bangladesh: Updates from the Project’ by the International Centre for Diarrhoeal Disease Research, Bangladesh
- ‘Supporting sustainable VL control & elimination in Nepal’ by B. P. Koirala Institute of Health Sciences
- ‘Supporting the national Vector Control strategy in Nepal through capacity development’ by the Institute of Tropical Medicine Antwerp and B. P. Koirala Institute of Health Sciences
- ‘Accelerating elimination through data driven decision making for active case detection’ by KalaCORE/Mott MacDonald
- ‘ACD in Bihar’ by IPE Global Limited
- ‘Community Based Intervention on Kala-Azar in Highly Endemic Areas’ by Project Concern International
- ‘IEC/BCC Activities for Kala-azar Elimination supported by KalaCORE’ by New Concept Information Systems
Monitoring & Evaluation studies for end-line evaluation of KalaCORE
As we are approaching the end of the programme, KalaCORE’s Monitoring & evaluation taskforce (based at the London School of Hygiene and Tropical Medicine) have been conducting end-line evaluation studies. Together with base-line studies which were conducted earlier in the programme, end-line studies will help understand the impact and effectiveness of control and elimination activities during KalaCORE in each of the 6 VL-endemic countries of focus.
We anticipate a range of important insights from these studies.
The team are bringing qualitative and quantitative data together from the studies presented in the Table below. More information for the types of studies is also listed below.
KalaCORE M&E end-line studies per country
Types of studies
Endline patient survey: To evaluate the treatment seeking practices, diagnosis and treatments received, and household economic burden of VL in endemic areas of Ethiopia, Sudan and India pre and post implementation of KalaCORE interventions.
Theory of Change (ToC): To evaluate the contribution of the KalaCORE programme to reducing the health and economic impact of VL in Bangladesh, Nepal, India, Ethiopia, South Sudan and Sudan using a Theory of Change (ToC) approach.
- Desk review: constructing individual country ToC and populating them with data from secondary analyses to identify successes and bottlenecks;
- Stakeholders interview: investigating the drivers of success, bottlenecks, and the influence of contextual factors using in-depth interviews
Extension studies: to explore further the VL post-treatment economic burden from a household perspective, and to gain a better understanding of the health seeking behaviour and drivers of accrual of costs.
- Pathway to treatment: To gain deeper understanding of VL patients and health providers knowledge and health seeking behaviour choices
- Long term VL patient follow-up: To assess the physical and economic burden of VL approximately six months after treatment and to explore the availability and potential impact of a government compensation on alleviating catastrophic economic costs for patients.
Revisiting the role of the slit-skin smear in the diagnosis of Indian post-kala-azar dermal leishmaniasis
This study examines the functionality of the slit-skin smear examination for the diagnosis of PKDL, by comparing slit-skin method to tissue biopsy methods using quantitative Real-time PCR (Q-PCR). Researchers report that slit-skin smear examination has a higher sensitivity than tissue biopsy.
Age trends in asymptomatic and symptomatic Leishmania donovani infection in the Indian subcontinent: A review and analysis of data from diagnostic and epidemiological studies
"As the elimination target for visceral leishmaniasis (VL) in the Indian subcontinent (<1 case/10,000 people/year) is approached, there is a growing need for surveillance tools with which to monitor transmission to ensure the target is sustained, especially given the large proportion of infections which are asymptomatic (~75–95%). One potential approach to estimate underlying transmission patterns may be to track age patterns in infection or cumulative exposure using diagnostic tests. However, current understanding of age patterns in asymptomatic infection and clinical VL is poor, in particular regarding possible age-dependence of infection rates. Our systematic review and pooled-analysis of age-stratified data on infection prevalence and disease incidence suggests that available diagnostics, as currently implemented, fail to meet the requirements for a reliable tool for assessing transmission, due to inconsistent standardisation and highly variable age-prevalence patterns across different settings. It also finds weak evidence for infection rates increasing with age, though further longitudinal studies are needed to test this hypothesis and to assess whether properly standardised diagnostic tests could be used to monitor ongoing transmission."
To ensure research and policy-shaping KalaCORE outputs reach wide and target audiences, we have put together a short Good Publication Guide. The Guide is aimed at members and partners of KalaCORE and it enlists recommendations to bear into consideration when publishing KalaCORE outputs.