Paritosh Malaviya

Banaras Hindu University | BHU · Department of Medicine

Objectives Monitoring of Leishmania transmission is considered a strategic priority for sustaining elimination of visceral leishmaniasis as a public health problem in the Indian subcontinent. The objective of this study was to evaluate whether serological surveys can distinguish between communities with and without Leishmania transmission, and to a...

Introduction Visceral leishmaniasis (VL) is a parasitic disease with an estimated 30 000 new cases occurring annually. Despite anaemia being a common haematological manifestation of VL, the evolution of different haematological characteristics following treatment remains poorly understood. An individual participant data meta-analysis (IPD-MA) is pl...

Background Co-endemicity of neglected tropical diseases (NTDs) necessitates that these diseases should be considered concomitantly to understand the relationship between pathology and to support disease management and control programs. The aims of the study were to assess the prevalence of filarial infection in asymptomatic Leishmania donovani infe...

Introduction Visceral leishmaniasis (VL) is a parasitic disease with an estimated 30 000 new cases occurring annually. There is an observed variation in the efficacy of the current first-line therapies across different regions. Such heterogeneity could be a function of host, parasite and drug factors. An individual participant data meta-analysis (I...

Background It has been amply described that levels of IgM antibodies against Mycobacterium leprae ( M. leprae ) phenolic glycolipid I (PGL-I) correlate strongly with the bacterial load in an infected individual. These findings have generated the concept of using seropositivity for antibodies against M. leprae PGL-I as an indicator of the proportion...

Visceral leishmaniasis (VL) is on the verge of elimination on the Indian subcontinent. Nonetheless, the currently low VL-incidence setting brings along new challenges, one of which is the validity of the diagnostic algorithm, based on a combination of suggestive clinical symptoms in combination with a positive rK39 Rapid Diagnostic Test (RDT). With...

Background Bangladesh, India, and Nepal aim for the elimination of Visceral Leishmaniasis (VL), a systemic parasitic infectious disease, as a public health problem by 2020. For decades, male patients have comprised the majority of reported VL cases in this region. By comparing this reported VL sex ratio to the one observed in population-based studi...

Introduction Post-kala-azar dermal leishmaniasis (PKDL) is a skin manifestation that is a late clinical outcome of visceral leishmaniasis (VL). Its presentation is similar to leprosy, and the differential diagnosis is not always easy. In VL endemic rural areas of Bihar, India, both infectious diseases co-exist. This observational study aimed to det...

Background Asymptomatic Leishmania donovani infections outnumber clinical presentations, however the predictors for development of active disease are not well known. We aimed to identify serological, immunological and genetic markers for progression from L. donovani infection to clinical Visceral Leishmaniasis (VL). Methods We enrolled all residen...

Schematic of study design. (DOCX)

Background Despite the overall decrease in visceral leishmaniasis (VL) incidence on the Indian subcontinent, there remain spatiotemporal clusters or ‘hotspots’ of new cases. The characteristics of these hotspots, underlying transmission dynamics, and their importance for shaping control strategies are not yet fully understood and are investigated i...

Age distribution among the population located within annual visceral leishmaniasis (VL) hotspots (panel A) and outside of the hotspots (panel B), where ‘n’ is the total number of population. (TIF)

Association between the average age of visceral leishmaniasis (VL) cases and annual incidence at the hamlet level. The black dashed line shows the regression line representing the association between the average age of VL cases per hamlet per year and the annual VL incidence at hamlet level. (TIF)

Temporal autocorrelation in annual visceral leishmaniasis (VL) incidence rates at hamlet level between 2007 and 2015, showing that VL incidence is temporally clustered within a hamlet up to 1.6 years. (DOCX)

Age of reported visceral leishmaniasis (VL) cases during the upward phase (n = 33 cases) (panel A) and downward phase (n = 46 cases) (panel B) of an outbreak. The bars represent the percentage (on a log scale) of reported VL cases. (TIF)

Moran’s I index, estimating spatial autocorrelation in annual visceral leishmaniasis (VL) incidence rates at hamlet level between 2007 and 2015. (DOCX)

Significant (p<0.05) spatial and spatiotemporal clusters of high visceral leishmaniasis (VL) incidence or ‘hotspots’ detected with Kulldorff spatial scan statistics for each year. (DOCX)

Semivariogram fitted on the annual incidence data at hamlet level for predicting the maximum distance beyond which there is little or no autocorrelation. (TIF)

Asset index distribution (‘1’ poorest to ‘5’ wealthiest) of visceral leishmaniasis (VL) cases detected between 2007 and 2015 living within hotspots (panel A) and outside of the hotspots (panel B), where ‘n’ is the total number of cases detected. (TIF)

In the Indian subcontinent, visceral leishmaniasis (VL) has a strongly clustered distribution. The "index case approach" is promoted both for active case finding and indoor residual spraying (IRS). Uncertainty exists about the optimal radius. Buffer zones of 50-75 m around incident cases have been suggested for active case finding, for IRS the reco...

Introduction Visceral Leishmaniasis (VL) is a fatal vector borne infectious disease transmitted by P. argentipes sand flies. The elimination program targets on vector control by indoor residual spraying (IRS) using DDT twice a year. As per our another survey conducted in the 50 villages in the highly endemic district of Muzaffarpur in India, the IRS...

Background and rationale Visceral leishmaniasis (VL) or kala-azar is a chronic infectious disease which poses a public health problem in the Indian subcontinent, East Africa and South America. In 2012, the estimated worldwide number of new cases of VL was between 200,000 and 400,000. Bangladesh, India and Nepal have entered into a joint commitment...

Human visceral Leishmaniasis (VL) or commonly known as kala-azar is vector born infectious disease transmitted by Phlebotomine argentipes sandflies. The disease is highly endemic in Bihar state of India and is fatal if left untreated. VL is a neglected tropical disease and Indian government targets to eliminate it from the region by 2018. Active ca...

Background: Visceral Leishmaniasis (VL) is a vector-borne infectious disease, caused by the protozoan Leishmania donovani,which is transmitted by phlebotomine sand flies. In an earlier study in Bihar, India, we found an association between incidence of VL and housing conditions. In the current study we investigated the influence of housing structur...

Visceral Leishmaniasis (VL) is a vector-borne infectious disease, caused by the protozoan Leishmania donovani, which is transmitted by phlebotomine sand flies. In an earlier study in Bihar, India, we found an association between incidence of VL and housing conditions. In the current study we investigated the influence of housing structure and condi...

The Muzaffarpur-TMRC Health and Demographic Surveillance System (HDSS), established in 2007, was developed as an enlargement of the scope of a research collaboration on the project Visceral Leishmaniasis in Bihar, which had been ongoing since 2005. The HDSS is located in a visceral leishmaniasis (VL)-endemic area in the Muzaffarpur district of Biha...

Introduction: Asymptomatic persons infected with the parasites causing visceral leishmaniasis (VL) usually outnumber clinically apparent cases by a ratio of 4–10 to 1. We assessed the risk of progression from infection to disease as a function of DAT and rK39 serological titers. Methods: We used available data on four cohorts from villages in India...

Asymptomatic persons infected with the parasites causing visceral leishmaniasis (VL) usually outnumber clinically apparent cases by a ratio of 4-10 to 1. We assessed the risk of progression from infection to disease as a function of DAT and rK39 serological titers. We used available data on four cohorts from villages in India and Nepal that are hig...

Objectives: To determine whether medical staff at PHC level would have the time to take up additional activities such as 1-day fever camps for active VL case detection. Methods: This article assessed the workload of health staff of different professional categories working at health facilities in Bangladesh, India and Nepal. Data were collected...

Objective: To evaluate a new tool for the monitoring of Visceral Leishmaniasis (VL) treatment outcomes in primary healthcare (PHC) settings, adapted from the standardised Retrospective Quarterly Cohort Monitoring done in tuberculosis control. Methods: We developed standard case definitions for early and late VL treatment outcomes, a single regis...

STROBE checklist. (DOC)

Asymptomatic persons infected with the parasites causing visceral leishmaniasis (VL) usually outnumber clinically apparent cases by a ratio of 4-10 to 1. We describe patterns of markers of infection and clinical VL in relation to age in Bihar, India. We selected eleven villages highly endemic for . During a 1-year interval we conducted two house to...

Introduction: In 2005 a visceral leishmaniasis (VL) elimination initiative was launched on the Indian subcontinent; important components of early case finding and treatment are entrusted to the primary health care system (PHC). In an earlier study in Bihar, India, we discovered some major shortcomings in implementation, in particular related to mo...

Background Active case detection (ACD) significantly contributes to early detection and treatment of visceral leishmaniasis (VL) and post kala-azar dermal leishmaniasis (PKDL) cases and is cost effective. This paper evaluates the performance and feasibility of adapting ACD strategies into national programs for VL elimination in Bangladesh, India an...

To identify factors associated with incidence of visceral leishmaniasis (VL), we surveyed 13,416 households in Bihar State, India. VL was associated with socioeconomic status, type of housing, and belonging to the Musahar caste. Annual coverage of indoor residual insecticide spraying was 12%. Increasing such spraying can greatly contribute to VL co...

. National VL Elimination Programs in India, Nepal and Bangladesh face challenges as home-based Miltefosine treatment is introduced. Objectives . To study constraints of VL management in endemic districts within context of national elimination programs before and after intervention. Methods . Ninety-two and 41 newly diagnosed VL patients were inter...

In 2009, a random survey was conducted in Muzaffarpur district to document the clinical outcomes of visceral leishmaniasis patients (VL) treated by the public health care system in 2008, to assess the effectiveness of miltefosine against VL. We analysed the operational feasibility and cost of such periodic random surveys as compared with health fac...

SIR year wise from 1990–2008 (0.75 MB JPG)

Month wise SIR 2002–2004 (0.59 MB JPG)

Month wise SIR 2005–2008 (0.59 MB JPG)

Background Visceral Leishmaniasis (VL) is a vector-borne disease transmitted by Phlebotomus argentipes. To understand the VL seasonality, annual and monthly variations of VL incidence and its relationship to meteorological variables, the numbers of VL cases reported in Muzaffarpur district, Bihar, India from 1990 to 2008 were studied. Methods Annu...

Studies investigating risk factors for visceral leishmaniasis (VL) on the Indian Subcontinent have shown contradictory results related to the role of domestic animals. In some studies having animals in or around the house was a risk factor, in others it was protective. We investigated the specific hypothesis that keeping domestic animals inside the...

In 2005 a visceral leishmaniasis (VL) elimination initiative was launched on the Indian subcontinent, with early diagnosis based on a rapid diagnostic test and treatment with the oral drug miltefosine as its main strategy. Several recent studies have signaled underreporting of VL cases in the region. Information on treatment outcomes is scanty. Our...