Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
Trans R Soc Trop Med Hyg. 2021 Mar 6;115(3):229-235. doi: 10.1093/trstmh/trab012.
In March 2020, India declared a nationwide lockdown to control the spread of coronavirus disease 2019. As a result, control efforts against visceral leishmaniasis (VL) were interrupted.
Using an established age-structured deterministic VL transmission model, we predicted the impact of a 6- to 24-month programme interruption on the timeline towards achieving the VL elimination target as well as on the increase of VL cases. We also explored the potential impact of a mitigation strategy after the interruption.
Delays towards the elimination target are estimated to range between 0 and 9 y. Highly endemic settings where control efforts have been ongoing for 5-8 y are most affected by an interruption, for which we identified a mitigation strategy to be most relevant. However, more importantly, all settings can expect an increase in the number of VL cases. This increase is substantial even for settings with a limited expected delay in achieving the elimination target.
Besides implementing mitigation strategies, it is of great importance to try and keep the duration of the interruption as short as possible to prevent new individuals from becoming infected with VL and continue the efforts towards VL elimination as a public health problem in India.
2020 年 3 月,印度宣布全国封锁以控制 2019 年冠状病毒病的传播。结果,针对内脏利什曼病(VL)的控制工作被中断。
我们使用已建立的年龄结构确定性 VL 传播模型,预测了为期 6-24 个月的项目中断对实现 VL 消除目标的时间线以及 VL 病例增加的影响。我们还探讨了中断后的缓解策略的潜在影响。
预计消除目标的延迟范围在 0 到 9 年之间。在已经开展了 5-8 年控制工作的高度流行地区,中断的影响最大,我们确定了一种缓解策略是最相关的。然而,更重要的是,所有地区都可能会出现 VL 病例的增加。即使在预计实现消除目标的延迟有限的地区,这种增加也是相当大的。
除了实施缓解策略外,尽量缩短中断的持续时间以防止新的个体感染 VL 并继续将 VL 作为印度的公共卫生问题进行消除,这一点非常重要。