Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India.
Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States.
Front Cell Infect Microbiol. 2021 Mar 9;11:641632. doi: 10.3389/fcimb.2021.641632. eCollection 2021.
Visceral leishmaniasis (VL) is a potentially deadly parasitic disease. In the Indian sub-continent, VL is caused by and transmitted the bite of an infected female sand fly, the only competent vector species in the region. The highest disease burden is in the northern part of the Indian sub-continent, especially in the state of Bihar. India, Bangladesh, and Nepal embarked on an initiative, coordinated by World Health Organization, to eliminate VL as a public health problem by the year 2020. The main goal is to reduce VL incidence below one case per 10,000 people through early case-detection, prompt diagnosis and treatment, and reduction of transmission using vector control measures. Indoor residual spraying, a major pillar of the elimination program, is the only vector control strategy used by the government of India. Though India is close to its VL elimination target, important aspects of vector bionomics and sand fly transmission dynamics are yet to be determined. To achieve sustained elimination and to prevent a resurgence of VL, knowledge gaps in vector biology and behavior, and the constraints they may pose to current vector control methods, need to be addressed. Herein, we discuss the successes and failures of previous and current vector-control strategies implemented to combat kala-azar in Bihar, India, and identify gaps in our understanding of vector transmission towards development of innovative tools to ensure sustained vector control in the post-elimination period.
内脏利什曼病（VL）是一种潜在致命的寄生虫病。在印度次大陆，VL 由 引起，并通过受感染的 雌性沙蝇叮咬传播，该沙蝇是该地区唯一具有传播能力的物种。疾病负担最高的地区是印度次大陆的北部，特别是在比哈尔邦。印度、孟加拉国和尼泊尔在世界卫生组织的协调下，启动了一项行动，旨在到 2020 年消除 VL 这一公共卫生问题。主要目标是通过早期发现病例、及时诊断和治疗，以及使用病媒控制措施减少传播，将 VL 发病率降低到每 10000 人以下。室内滞留喷洒是消除计划的主要支柱，也是印度政府唯一使用的病媒控制策略。尽管印度已接近 VL 消除目标，但仍有一些重要的病媒生物学和沙蝇传播动态方面有待确定。为了实现持续消除并防止 VL 死灰复燃，需要解决病媒生物学和行为方面的知识差距，以及它们可能对当前病媒控制方法构成的限制。在此，我们讨论了印度比哈尔邦为对抗黑热病而实施的先前和当前病媒控制策略的成功和失败，并确定了我们对病媒传播的理解存在差距，以便开发创新工具，确保在消除后时期持续进行病媒控制。
