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February 8, 2010PLoS neglected tropical diseasesOpen Access

Of Cattle, Sand Flies and Men: A Systematic Review of Risk Factor Analyses for South Asian Visceral Leishmaniasis and Implications for Elimination

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Authors

CBCaryn BernCenters for Disease Control and PreventionOCOrin CourtenayUniversity of WarwickJAJorge AlvarReal Academia Española

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Implication

Systematic review uncovers environmental and domestic risk factors for visceral leishmaniasis in South Asia, highlighting targeted interventions needed for disease elimination.

Key Points

  • To synthesize epidemiological risk factor analyses for visceral leishmaniasis in the Indian subcontinent, with an emphasis on clarifying the contradictory role of cattle to guide regional elimination strategies.
  • Conducted a systematic review of epidemiological studies published over the past decade evaluating risk factors for visceral leishmaniasis (kala-azar) across the Indian subcontinent.
  • Assessed data covering human reservoirs, spatial clustering, vector-promoting environmental exposures, host nutrition, and livestock presence.
  • Visceral leishmaniasis and subclinical infections exhibit pronounced household- and village-level clustering around index cases, with local saturation over several years followed by geographic shifting and subsequent waves of post-kala-azar dermal leishmaniasis (PKDL).
  • Mud walls, indoor dampness, and peridomestic vegetation elevate risk by supporting sand fly vector survival, whereas bed net use, sleeping on cots, and indoor residual spraying consistently confer protection.
  • Cattle presence demonstrates contradictory effects across studies, alternating between increased and decreased transmission risk due to opposing influences on vector abundance, aggregation, and host-feeding preferences.

Cite This Study

Bern et al. (2010) studied this question.

synapsesocial.com/papers/6a7473fb96d04a2f43f53eb7https://doi.org/10.1371/journal.pntd.0000599
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