Saurabh Suman
Assistant Professor, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.
Trop Doct. 2021 Jan;51(1):84-91. doi: 10.1177/0049475520953647. Epub 2020 Sep 9.
Cases of kala-azar reported during 2013-2018 in Bihar, India were retrospectively analysed. Of 2187 villages reporting cases of kala-azar in 2018, 573 (26.2%) had reported no case in the previous five years but contributed to 20% of disease burden in 2018. On applying potential thresholds of kala-azar outbreaks, 805, 519 and 103 villages reported more than twice, thrice and five times their previous five-year annual average in 2018, respectively. Indoor residual spraying (IRS) in villages reporting any case of kala-azar in the past three years as per current guidelines could cover 72% of incident cases in 2018 vis-a-vis 80% if villages reporting cases in the past five years were considered. Therefore, IRS may be expanded to villages reporting cases in the past five years. Village case trends can be utilised to configure potential outbreak alarms (early warning and response system) on a pre-organised dashboard. A data-driven strategy for villages newly reporting cases and those in potential outbreak situations could prove effective in achieving and sustaining the elimination of kala-azar.
对印度比哈尔邦2013 - 2018年期间报告的黑热病病例进行了回顾性分析。在2018年报告有黑热病病例的2187个村庄中，有573个（26.2%）在过去五年中未曾报告过病例，但却占了2018年疾病负担的20%。应用黑热病暴发的潜在阈值时，2018年分别有805个、519个和103个村庄报告的病例数超过其过去五年年均病例数的两倍、三倍和五倍。按照现行指南，对过去三年报告过任何黑热病病例的村庄进行室内滞留喷洒（IRS），2018年可覆盖72%的新发病例；若考虑过去五年报告过病例的村庄，则可覆盖80%的新发病例。因此，IRS可扩大至过去五年报告过病例的村庄。村庄病例趋势可用于在预先设置的仪表板上配置潜在的暴发警报（早期预警和应对系统）。对于新报告病例的村庄以及处于潜在暴发情况的村庄，数据驱动的策略可能在实现和维持消除黑热病方面证明是有效的。
