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Impact of Changes in Detection Effort on Control of Visceral Leishmaniasis in the Indian Subcontinent

Coffeng, Luc, Le Rutte, Epke A., Muñoz, Johanna, Adams, Emily R. ORCID:, Prada, Joaquin M., de Vlas, Sake J. and Medley, Graham F. (2020) 'Impact of Changes in Detection Effort on Control of Visceral Leishmaniasis in the Indian Subcontinent'. Journal of Infectious Disease, Vol 220, Issue S5, S546-S553.

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Control of visceral leishmaniasis (VL) on the Indian subcontinent relies on prompt detection and treatment of symptomatic cases. Detection effort influences the observed VL incidence and how well it reflects the underlying true incidence. As control targets are defined in terms of observed cases, there is an urgent need to understand how changes in detection delay and population coverage of improved detection affect VL control.Methods
Using a mathematical model for transmission and control of VL, we predict the impact of reduced detection delays and/or increased population coverage of the detection programmes on observed and true VL incidence and mortality.
Improved case detection, either by higher coverage or reduced detection delay, causes an initial rise in observed VL incidence before a reduction. Relaxation of improved detection may lead to an apparent temporary (1-year) reduction in VL incidence, but comes with a high risk of resurging infection levels. Duration of symptoms in detected
cases shows an unequivocal association with detection effort.
VL incidence on its own is not a reliable indicator of the performance of case detection programmes. Duration of symptoms in detected cases can be used as an additional marker of the performance of case detection programmes.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 715 Visceral leishmaniasis
WR Dermatology > Parasitic Skin Diseases > WR 350 Tropical diseases of the skin. Mucocutaneous leishmaniasis. Leishmaniasis
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI):
Depositing User: Cathy Waldron
Date Deposited: 02 Jan 2020 13:38
Last Modified: 20 Jul 2020 11:04


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