Intervention Packages for Early Visceral Leishmaniasis Case Detection and Sandfly Control in Bangladesh: A Comparative Analysis
KalaCORE HSR2018 Poster “Evidence-based planning to maximise coverage of treatment services for Kala-Azar in resource constraint settings”
In the beginning of October 2018 (8-12), KalaCORE attended the Fifth Global Symposium on Health Systems Research, http://healthsystemsresearch.org/hsr2018/ in Liverpool, UK.
The symposium takes place every two years and brings a range of actors in health systems and policy research together. Being the fortieth anniversary of the Alma-Ata declaration this year, HSR2018 focused on both on current and emerging challenges and solutions in romoting and achieving health for all. Dr Kingsuk Misra presented key learnings on strategic planning and implementation for VL elimination in India.
- To reference the poster:Misra, M., Aggarwal, V., Burza, S., 2018. ‘Evidence Based Planning to Maximise Coverage of Treatment Services for Kala-Azar in Resource Constraint Settings in India’, poster presented at the Fifth Global Symposium on Health Systems Research: Liverpool, United Kingdom, 8-12 October 2018.
- See also: Watkins, D. A., Yamey, G., Schäferhoff, M., Adeyi, O., Alleyne, G., Alwan, A., Berkley, S., Feachem, R., Frenk, J., Ghosh, G., Goldie, S. J., Guo, Y., Gupta, S., Knaul, F., Kruk, M., Nugent, R., Ogbuoji, O., Qi, J., Reddy, S., Saxenian, H., Soucat, A., Jamison, D. T., Summers, L. H. 2018. ‘Alma-Ata at 40 years: reflections from the Lancet Commission on Investing in Health’. Lancet, 20;392(10156):1434-1460. doi: 10.1016/S0140-6736(18)32389-4.
Second run of open-access on-line course "The Control and Elimination of Visceral Leishmaniasis (kala-azar)"
Start date: Monday, 7th of January 2019
Developed by the London School of Hygiene and Tropical Medicine with invaluable guidance, expertise and training material from KalaCORE partners and the support of UK aid by the UK government, we invite you to join the second run of our open-access on-line course on the Control and Elimination of Visceral Leishmaniasis.
The course serves as a unique platform to learn about the practical tools, and the requirements and the complexities of VL control and elimination programmes. Topics covered include:
• An introduction to the basic biology and epidemiology of VL
• Clinical management, diagnosis and treatment
• Sand fly biology, behaviour and VL vector control tools
• Other key tools to strengthen VL control and elimination programmes including surveillance, monitoring and evaluation, outbreak management, health systems and community health education.
The course is available on the online educational platform, FutureLearn and it is suitable for anyone who is directly involved with, or interested in, the disease. We recommend that you take advantage of a unique opportunity by the “Study UK campaign” and gain free “Upgrade” access to our course on FutureLearn, https://www.futurelearn.com/study-uk (Deadline: 16 January 2019).
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Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study
"Ethiopia bears a high burden of visceral leishmaniasis (VL)—a neglected tropical disease transmitted through the bite of a sand fly that disproportionately affects vulnerable populations. Without treatment, VL progresses, causing increasingly severe symptoms and ultimately death within two years, in most cases. Early access to VL diagnosis and care improves clinical prognosis and reduces transmission from infected humans; however, significant obstacles exist. To our knowledge, our study is the first in Ethiopia to use qualitative methods to assess barriers to VL diagnosis and care among seasonal mobile workers. Strikingly, we found that contrary to what health policy for VL dictates in this endemic setting, study participants reported very poor access to diagnosis and, consequently, significantly delayed access to treatment. Our findings have important public health and policy implications. Specifically, our results offer strategies that may increase access to VL diagnosis and care, allowing for earlier treatment and better prognoses for VL patients, and reducing the potential health disparities and the overall burden of VL."
Published by the National Kala-azar Elimination Program (NKEP), Communicable Disease Control (CDC), Disease control Unit, Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MoHFW), Government of the People’s Republic of Bangladesh in August of 2016.
Published by the National Kala-azar Elimination Program (NKEP), Communicable Disease Control (CDC), Disease control Unit, Directorate General of Health Services (DGHS), Ministry of Health and Family Welfare (MoHFW), Government of the People’s Republic of Bangladesh in 2018.
A xenodiagnosis study on PKDL and VL patients using laboratory-reared Phlebotomus argentipes was conducted to determine whether PKDL patients can act as an infection reservoir. The study concludes that nodular and macular PKDL, and VL, can be infectious to sand flies. The authors therefore advise that "active PKDL case detection and prompt treatment should be instituted and maintained as an integral part of VL control and elimination programs".
This paper examines the history of Miltefosine, the only oral drug for VL management, and issues of access across different geographical areas.
KalaCORE NNN 2018 Presentation slides “How can the NNN address stronger advocacy for improved health care services for seasonal migrant workers in Ethiopia?”
In September 2018, KalaCORE participated in the Ninth NNN conference in Addis Ababa hosted by the Federal Ministry of Health of Ethiopia. The conference focused on sharing knowledge and lessons learned, within the BEST (Behaviour, Environment, Social inclusion, Treatment and care) framework for sustainable NTD control and elimination. Drawing from VL control activities in Ethiopia, supported by KalaCORE, Dr Cherinet Adera spoke about “How can the NNN address stronger advocacy for improved health care services for seasonal migrant workers in Ethiopia?”
A Poster was also presented. See page 31 in the Full report from the conference http://www.ntd-ngonetwork.org/sites/default/files/uploaded/NNN%20Full%20Report%20FINAL.pdf
- To reference the slides: Adera, C., Gelaw, A., Meredith, S., Den Boer, M., Rowan, S. 2018. 'How the NNN can address stronger advocacy for improved health care services for seasonal migrant workers, with a focus on Ethiopia', slides presented at the Ninth NNN Conference: Addis Ababa, Ethiopia, 24-26 September 2018.
- To reference the poster: Adera, C., Gelaw, A., Meredith, S., Den Boer, M., Rowan, S. 2018. 'How the NNN can address stronger advocacy for improved health care services for seasonal migrant workers, with a focus on Ethiopia', poster presented at the Ninth NNN Conference: Addis Ababa, Ethiopia, 24-26 September 2018. In NNN Conference Report, 2018.
The role of case proximity in transmission of visceral leishmaniasis in a highly endemic village in Bangladesh
"Visceral leishmaniasis (VL), a fatal parasitic disease transmitted by sandflies, has been targeted for elimination as a public health problem in the Indian subcontinent by 2020. The goal has been reached in the majority of endemic regions in Bangladesh, India and Nepal, but the disease persists in several hotspots. Better understanding of spatial clustering of VL cases and the role of asymptomatically infected individuals in transmission is required to improve control interventions and sustain the elimination target. To address this issue, we have fitted an individual-level spatiotemporal model of VL transmission to geo-located incidence data from Bangladesh to estimate the rate at which VL risk decreases with distance from a case and the potential contribution of asymptomatic individuals to transmission. Our results suggest that VL risk decreases quickly with distance and that symptomatic individuals are the main drivers of transmission, highlighting the potential for spatially-targeted control interventions to reduce transmission".