Intensely clustered outbreak of visceral leishmaniasis (kala-azar) in a setting of seasonal migration in a village of Bihar, India
BMC Infectious Diseases·
- DOI
- 10.1186/s12879-019-4719-3
- PMID
- —
- PMCID
- —
- OpenAlex
- W3004774885
- Study type
- Outbreak investigation
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The outbreak demonstrates vulnerability in low-endemic areas and highlights gaps in case-finding, treatment delays, incomplete vector control coverage, and the role of social and economic determinants in kala-azar transmission. The findings underscore the need for a routine outbreak response framework within the elimination programme.
Structured evidence summary
Research question
The investigation aimed to characterize a visceral leishmaniasis outbreak in a village in Bihar, India, and identify contributing factors.
Study design
Outbreak investigation involving house-to-house case search, rapid diagnostic testing of suspects and contacts, and entomological studies including sandfly collection and cone bio-assay.
Population and setting
The outbreak occurred in Kosra village, Sheikhpura district, a low-endemic area of Bihar, India. The southern hamlet was predominantly inhabited by socio-economically disadvantaged seasonal migrant workers.
Main findings
Seventy kala-azar cases were reported through December 2018, with intense spatial and temporal clustering in the southern hamlet (attack rate 19.0% versus 0.5% in the rest of the village). Delay between diagnosis and treatment of the index case exceeded one year. The median time from fever onset to diagnosis was 30 days. Three-quarters of cases incurred out-of-pocket medical expenses. Only half of affected dwellings were fully sprayed, and post-spray entomological assessments indicated poor vector control effectiveness.
Public-health relevance
The outbreak demonstrates vulnerability in low-endemic areas and highlights gaps in case-finding, treatment delays, incomplete vector control coverage, and the role of social and economic determinants in kala-azar transmission. The findings underscore the need for a routine outbreak response framework within the elimination programme.
Important limitations
This summary is limited to the supplied single-article abstract and metadata. The original paper is required for decision-grade interpretation of methods, confounders, sample representativeness, and generalizability.
GIDS interpretation
The article describes a completed outbreak investigation and is indexed for kala-azar and leishmaniasis in India under outbreak investigation and transmission dynamics topics. It provides context on outbreak drivers but does not constitute live surveillance data.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 9 auditable classifier relationships to diseases, places, topics, and study design.