Volume 3, Issue 1, March 2019, Page: 6-14
A Review on Major Risk Factors and Current Status of Visceral Leishmaniasis in North India
Naveen Samuel Singh, Department of Zoology, Lucknow Christian College, Lucknow, India
Doris Phillips Singh, Department of Zoology, Lucknow Christian College, Lucknow, India
Received: Nov. 26, 2018;       Accepted: Jan. 2, 2019;       Published: Jan. 31, 2019
DOI: 10.11648/j.aje.20190301.12      View  647      Downloads  162
In India, more than 1,00,000 people are affected every year by Visceral Leishmaniasis (VL). VL is a chronic and fatal disease caused by Leishmania donovani parasites which are transmitted by infected female sand flies, Phlebotomus argentipes. Ninety percent of total cases of the world are reported from India, Bangladesh and Sudan. Several districts of the state Bihar show the occurrence of VL. This is 40-50% of the world cases and 90% of the cases in India. Conversely, information on epidemiology of kala-azar in India remains scanty due to inadequate studies about the various risk factors associated with VL. The present review contributes to the study of the number of cases, deaths, prevalence and incidence caused by VL, spatial distribution, basic epidemiologic features, the vector biology, transmission of the parasite, hosts and most importantly the major risk factors viz. climatic, the physical and biotic factors, the socio-economic conditions, the environmental factors, deforestation due to urbanization, domestic animals and the living standard. For this study we chose five states in India; Bihar, Uttarakhand, Uttar Pradesh, Jharkhand and West Bengal. The study period was from 2010-2017. A decreasing trend was observed in the number of incidences, cases and deaths. But on the contrary, the Post Kala Azar Dermal Leishmaniasis cases (PKDL) showed an increasing trend. The Gram Pradhans (Heads of Villages) and the villagers were also questioned regarding the associated risk factors viz. housing conditions- kaccha (mud) houses, poverty, use of bed nets, cleanliness, damp floors, cooking fuel, vegetation, the rearing of the domestic animals etc. The study suggests that the control measures have been effective in suppressing/eradicating VL but seeing the PKDL trend it also leaves a suspicion that apart from P. argentipus some other flies may also be playing the role as vectors in the transmission of VL. To decrease the transmission of Leishmania donovani and to achieve the goal of total eradication of VL from India in near future, a better understanding of the biology underlying transmission and disease with the major risk factors is the pressing need.
Control Measures, Endemic, India, Incidence, Leishmaniasis, Phlebotomine, Risk Factors
To cite this article
Naveen Samuel Singh, Doris Phillips Singh, A Review on Major Risk Factors and Current Status of Visceral Leishmaniasis in North India, American Journal of Entomology. Vol. 3, No. 1, 2019, pp. 6-14. doi: 10.11648/j.aje.20190301.12
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WHO, (1998) Life in the 21st century: A vision for all. World Health Report -1998. Geneva: World Health Organization.
WHO, (1990) Control of the Leishmaniasis. Report of a World Health Organization Expert Committee. World Health Organ Tech Rep Ser793: 1-158.
WHO, (1995) Bridging the gap: World Health Report Geneva: World Health Organization.
Maroli, M., Rossi, L., Baldelli, R., Capelli, G. and Ferroglio, E., et al. (2008) The northward spread of leishmaniasis in Italy: evidence from retrospective and ongoing studies on the canine reservoir and phlebotomine vectors. Trop Med Int Health 13: 256-264.
Morosetti, G., Bongiorno, G., Beran, B., Scalone, A. and Moser, J., et. al. (2009) Risk assessment for canine leishmaniasis spreading in the north of Italy. Geospatial Health 4: 115-127.
Silva, G. A. R., Boechat, T. O., Ferry, F. R. A., Pinto, J. F. C. and Azevedo, et al. (2014) First case of autochthonous human visceral leishmaniasis in the ban Center of Rio de Janeiro: Case report. Rev Inst Med Trop Sao Paulo 56: 81-84.
Bogdan, C., Schonian, G., Banuls, A. L., Hide, M. and Pratlong, F., et al. (2001) Visceral leishmaniasis in a German child who had never entered a known endemic area: Case report and review of the literature. Clin Infect Dis 32: 302-306.
Koehler, K., Stechele, M., Hetzel, U., Domingo, M. and Schonian, G., et al. (2002) Cutaneous leishmaniosis in a horse in southern Germany caused by Leishmania infantum. Vet Parasitol 109: 9-17.
Müller, N., Welle, M., Lobsiger, L., Stoffel, M. H. and Boghenbor, K. K., et al. (2009) Occurrence of Leishmania sp. in cutaneous lesions of horses in Central Europe. Vet Parasitol 166: 346-351.
Killick-Kendrick, R. (1999) The biology and control of phlebotomine sand flies. Clin Dermatol 17: 279-289.
Sharma, U., Redhu, N. S., Mathu, R P. and Singh, S. (2007) Re-emergence of visceral Leishmaniasis in Gujarat, India. J Vect Borne Dis 44: 230-232.
Joshi, A., Narain, J. P., Prasittisuk, C., Bhatia, R. and Hashim, G., et al (2008) Can Visceral Leishmaniasis be eliminated from Asia? Vector Borne Diseases 45: 105-111.
NVBDCP, (2017) NVBDCP Ministry of Health & Family Welfare, Government of India, 2010-2017.
Thakur, C. P. (1992) Treatment of kala-azar in India. National Med J of India 5: 203-205.
Sundar, S. and Murray, H. W. (1995) Gamma interferon in the treatment of kala-azar and other forms of Leishmaniasis. The J. of the Asso of Physicians of India 43: 348-350.
Desjeux, P. (2004) Leishmanias: Current situation and new perspectives. Comp Immunol Microbiol Infect Dis 27: 305-318.
Swaminath, C. S. and Supa Kankunti, S. (1942) Transmission of Indian kala-azar to man by the bite of Phlebotomus. argentipes, Annandale & Brunetti. The Indian J of Med Res 30: 473-477.
Lainson, R. and Rangel, E. F. (2005) Lutzomyia longipalpis and the eco-epidemiology of American visceral leishmaniasis, with particular reference to Brazil- A Review. Mem Inst Oswaldo Cruz 100: 811-827.
Belo, V. S., Werneck, G. L., Barbosa, D. S., Simões, T. C. and Nascimento, B. W. L., et al. (2013) Factors associated with visceral leishmaniasis in the Americas: a systematic review and meta-analysis. PLoS Neg Trop Dis 7:e2182.
Belo, V. S., Struchiner, C. J., Werneck, G. L., Barbosa, D. S. and de Oliveira, R. B., et al. (2013) A systematic review and meta-analysis of the factors associated with Leishmania infantum infection in dogs in Brazil. Veterinary parasitology 195: 1-13.
Jones, K. E., Patel, N. G., Levy, M. A., Storegard, A. and Balk, D., et al (2008) Global trends in emerging infectious diseases. Nature 451: 990-993.
Lindgren, E. and Naucke, T. J. (2006) Leishmaniasis: Influences of climate and climate change: Epidemiology, ecology and adaption measures. In: Climate change and adaptation strategies for human health. Darmstadt: Springer. Menne, B., Ebi, K. L., Eds. Pp. 131-156.
Camargo, L. B. and Langoni, H. (2006) Impact of leishmaniasis on public health. J Venom Anim Toxins Trop Dis 12: 527-548.
Dujardin, J. C., Campino, L., Cañavate, C., Dete, J. P. and Gradoni, L., et al. (2008) Spread of vector-borne diseases and neglect of leishmaniasis, Europe. Emerg Infect Dis 14: 1013-1018.
Aspöck, H., Gerersdorfer, T., Formayer, H. and Walochnik, J. (2008) Sandflies and sandfly-borne infections of humans in Central Europe in the light of climate change. Wien Klin Wochen 120: 24-29.
Cross, E. R. and Hyams, K. C. (1996) The potential effect of global warming on the geographic and seasonal distribution of Phlebotomuspapatasi in Southwest Asia. Environ Health Perspect 104: 724-727.
Gebre-Michael, T., Malone, J. B., Balkew, M., Ali, A. and Berhe, N., et al. (2004) Mapping the potential distribution of Phlebotomus martini and P. orientalis (Diptera: Psychodidae), vectors of kala-azar in East Africa by useof geographic information systems. Acta Trop 90: 73-86.
Oshagi, M. A., Ravasan, N. M., Javadian, E., Rassi, Y. and Sadraei, J., et al. (2009) Application of predictive degree day model for field development of sandfly vectors of visceral leishmaniasis in northwest of Iran. J Vector Borne Dis 46: 247-255.
Aransay, A. M., Testa, J. M., Morillas-Marquez, F., Lucientes, J. and Ready, P. D. (2004) Distribution of sandfly species in relation to canine leishmaniasis from the Ebro Valley to Valencia, northeastern Spain. ParasitolRes 94: 416-420.
Killick-Kendrick, R., Wilkes, T. J., Bailly, M., Bailly, I. and Right on, L. A. (1986) Preliminary field observations on the flight speed of a phlebotominesandfly. Trans R Soc Trop Med Hyg 80: 138-142.
Ximenes, M., Castellon, E. G., Souza, M., Lara Menezes, A. A. and Queiroz, J. W., et al. (2006) Effect of abiotic factors on seasonal population dynamics of Lutzomyia longipalpis (Diptera: Psychodidae) in northeastern Brazil. J Med Entomol 43: 990-995.
Galvez, R., Descalzo, M. A., Miro, G., Jimenez, M. I. and Martin, O., et al (2010) Seasonal trends and spatial relations between environmental/meteorological factors and leishmaniasis sand fly vector abundances in Central Spain. Acta Trop 115: 95-102.
Orshan, L., Szekely, D., Khalfa, Z. and Bitton, S. (2010) Distribution and seasonality of Phlebotomus sand flies in cutaneous leishmaniasis foci, Judean Desert, Israel. J Med Entomol 47: 319-328.
Ghosh, K., Mukhopadhyay, J., Desai, M. M., Senroy, S. and Bhattacharya, A. (1999) Population ecology of Phlebotomusargentipes (Diptera: Psychodidae) in West Bengal, India. J Med Entomol 36: 588-594.
Sivagnaname, N. and Amalraj, D. D. (1997) Breeding habitats of vector sand flies and their control in India. J Commun Dis 29: 153-159.
Sawalha, S. S., Shtayeh, M. S., Khanfar, H. M., Warburg. A. and Abdeen, Z. A. (2003) Phlebotomine sand flies (Dipteria, Psychodidae) of the Palestinian West Bank: Potential vectors of leishmaniasis. J Med Entomol 40: 321-328.
Peterson, A. T., Pereira, R. S. and Neves, V. F. (2004) Using epidemiological survey data to infer geographic distributions of leishmaniasis vector species. Rev Soc Bras Med Trop 37: 10-14.
Peterson, A. T. and Shaw, J. (2003) Lutzomyia vectors for cutaneous leishmaniasis in Southern Brazil: ecological niche models, predicted geo-graphic distributions, and climate change effects. Int J Parasitol 33: 919-931.
Gonzales, C., Wang, O., Strutz, S. E., Gonza´les-Salazar, C. and Sanchez-Cordero, V., et al. (2010) Climate change and risk of leishmaniasis in North America: predictions from ecological niche models of vector and reservoir species. PLoS Negl Trop Dis 4: e585.
Thakur CP (2016) Is elimination of kala-azar feasible by 2017? Ind. J Med Res 144: 789-802.
Bhunia, G. S., Kumar, V., Kumar, A. J., Das, P. and Kesari, S. (2010) The use of remote sensing in the identification of the eco-environmental factors associated with the risk of human visceral leishmaniasis (kala-azar) on the Gangetic plain, in north-eastern India. Annals of Trop Med and Parasit 104: 35-53.
Parmesan, C. (2006) Ecological and evolutionary responses to recent climate change. Ann Rev Ecol Evol Syst 37: 637-669.
Fischer, D., Moeller, P., Thomas, S. M., Naucke, T. J. and Beierkuhnlein, C. (2011) Combining Climatic Projections and Dispersal Ability: A Method for Estimating the Responses of Sandfly Vector Species to Climate Change. PLoS Negl Trop Dis 5: e1407.
Palaniyandi, M., Anand, P. H. and Maniyosai, R. (2014) Climate, Landscape and the Environments of Visceral Leishmaniasis Transmission in India, Using Remote Sensing and GIS. J Geophys Remote Sensing 3: 122.
Singh, N. S. and Phillips-Singh, D. (2009) Seasonal occurrence of Phlebotominae sandflies (Phlebotominae: Diptera) and it’s correlation with kala-azar in eastern Uttar Pradesh, India. The Southeast Asian J of TropMed and Public Health 40: 458-462.
WHO, (2018) Leishmaniasis, Fact sheet.
Choi, C. M. and Lerner, E. A. (2001) Leishmaniasis as an emerging infection. J Investigative Dermatology Symp. Proceedings 6: 175-182.
Yadon, Z. E., Rodrigues, L. C., Davies, C. R. and Quigley, M. A. (2003) Indoor and peridomestic transmission of American cutaneous leishmaniasis in north western Argentina: a retrospective case-control study. Am J Trop Med Hyg 68: 519-526.
Saha, S., Ramachandran, R., Hutin, Y. J. F., Mohan, D. and Gupte, M. D. (2009) Visceral leishmaniasis is preventable in a highly endemic village in West Bengal, India. Transactions of The Royal Soc of Trop Med Hygiene 103: 737-742.
Bern, C., Joshi, A. B., Jha, S. N., Das, M. L. and Hightower, A., et al. (2000) Factors associated with visceral leishmaniasis in Nepal: bed-net use is strongly protective. Am J Trop Med Hyg 63: 184-188.
Bern, C., Hightower, A. W., Chawdhury, R., Ali, M. and Amann J., et al. (2005) Risk factors for Kala-azar in Bangladesh Emerg. Infect Dis 11: 655-662.
Thakur, C. P. (2000) Socio-economics of Visceral Leishmaniasis in Bihar (India). Trans R. Soc Trop Med Hyg 94: 156-157.
Schenkel, K., Rijal, S., Koirala, S., Koirala, S. and Vanlerberghe V., et al. (2006) Visceral leishmaniasis in southeastern Nepal: a cross-sectional survey on Leishmania donovani infection and its risk factors. Trop Med and Int Health 11: 1792-1799.
Ranjan, A., Sur, D., Singh, V. P., Siddique, N. A., and Manna, B., et al. (2005) Risk factors for Indian kala-azar. American Journal of Tropical Medicine and Hygiene 73: 74-78.
Singh, S. P., Hasker, E., Picado, A., Gidwani, K. and Malaviya, P., et al. (2010) Risk factors for visceral leishmaniasis in India: further evidence on therole of domestic animals. Trop Med and Inter Health 15: 29-35.
Boelaert, M., Meheus, F., Sanchez, A., Singh, S. P. and Vanlerberghe, V., et al. (2009) The poorest of the poor: a poverty appraisal of households affected by visceral leishmaniasis in Bihar, India. Trop Med Int Health 14: 639-644.
Pascual, Martinez F., Picado, A., Roddy, P. and Palma, P. (2012) Low casteshave poor access to visceral leishmaniasis treatment in Bihar, India. Trop Med Int Health 17: 666-673.
Armijos, R. X., Weigel, M. M., Izurieta, R., Racines, J. and Zurita, C., et al. (1997) The epidemiology of cutaneous leishmaniasis in subtropical Ecuador. Tropical Med Int Health 2: 140-152.
Sudhakar, S., Srinivas, T., Palit, A., Kar, S. K. and Bhattacharya, S. K. (2006) Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in partsof Bihar state, India: an RS and GIS approach. J. Vect. Borne Dis 43: 115-22.
Dinesh, D. S. and Dhiman, R. C. (1991) Plant sources of fructose to sandflies, particularly Phlebotomous argentipes in nature. J of Commu Dis 23: 160-161.
Dhiman, R. C. and Sen, A. B. (1991) Epidemiology of Kala-azar in rural Bihar (India) using village as a component unit of study. Indian J Med Res 93: 155-160.
Singh, N. S. and Phillips-Singh, D. (2010) Relative abundance of Phlebotominae sand flies with emphasis on vectors of kala-azar. Asian Paci JTrop Med 3: 270-271.
Salomón, O. D., Quintana, M. G., Bruno, M. R., Quiriconi, R. V. and Cabral, V. (2009) Visceral leishmaniasis in border areas: clustered distribution­ of phlebotomine sandflies in Clorinda, Argentina. Mem Inst Oswaldo Cruz 104: 801-804.
Desjeux, P. (2001) The increase in risk factors for leishmaniasis world-wide. Trans R Soc Trop Med Hyg 95: 239-243.
Pouche, D. M., Grant, W. E., and Wang, H. H. (2016) Visceral Leishmaniasis on the Indian Subcontinent: Modeling the dynamic relationship between vector control schemes and vector life cycles. PLOS Neglected Tropical Diseases 10: e0004868.
Singh, O. P., Hasker, E., Boelaert, M. and Sundar, S. (2016) Elimination of visceral leishmaniasis on the Indian subcontinent. The Lancet infectious diseases 16: e304-e309.
NVBDCP (2018) National Kala-azar Elimination Programme-2018 National Vector Borne Disease Control Programme (NVBDCP 2010-17), Directorate of Health Services, Ministry of Health and Family Welfare, New Delhi, India.
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