IngentaConnect Visceral leishmaniasis on the Indian sub-continent: a multi-centr...

Authors: Das, M.¹; Banjara, M.²; Chowdhury, R.³; Kumar, V.⁴; Rijal, S.¹; Joshi, A.²; Akhter, S.³; Das, P.⁴; Kroeger, A.⁵

Source: Annals of Tropical Medicine and Parasitology, Volume 102, Number 8, December 2008 , pp. 729-741(13)

Publisher: Maney Publishing

Abstract:

The sandflies that transmit the parasites causing human visceral leishmaniasis (VL) can be controlled by several methods, including indoor residual spraying (IRS), the use of long-lasting insecticidal nets (LLIN) and ecological vector management (EVM). The financial costs of each of these three methods of sandfly control have recently been assessed and compared, in a multi-centre study based on the Indian sub-continent. In each of the four study sites (two in Nepal and one each in India and Bangladesh), 24 neighbourhoods were randomly selected in districts with high incidences of VL. The costs of the three interventions were then prospectively assessed in each study neighbourhood, in the local currency, and then converted to U.S. dollars at the prevailing exchange rate in the country concerned.

The costs of IRS, which ranged from U.S.$2.4-11.7 (mean = U.S.$5.9) per household-year, were greater than those of LLIN (U.S.$3.5-5.1/household-year, with a mean of U. S.$4.5) but less than those of EVM (U. S.$5.0- 14.0/household-year, with a mean of U.S.$8.7). These results indicate that LLIN and IRS may be the cheaper options for the control of sandflies on the Indian sub-continent, and that EVM should perhaps only be taken up as a complimentary and voluntary method. Various combinations of these interventions (based on country-specific social and economic factors) may, however, be the best and most cost-effective choice.

Document Type: Research article

DOI: 10.1179/136485908X355274

Affiliations: 1: B. P. Koirala Institute of Health Sciences, Dharan - 56701, Nepal 2: Institute of Medicine, Tribhuvan University, Maharajganj, Kathmandu, Nepal 3: World Health Organization, Regional Office for South-east Asia, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi - 110 002, India 4: Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna - 800 007, India 5: Special Programme for Research and Training in Tropical Diseases, World Health Organization, 1211 Geneva 27, Switzerland, and Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, U.K

The full text electronic article is available for purchase. You will be able to download the full text electronic article after payment.

$51.00 plus tax

Visceral leishmaniasis on the Indian sub-continent: a multi-centre study of the costs of three interventions for the control of the sandfly vector, Phlebotomus argentipes