Anuj Mubayi|Carlos Castillo-Chávez|Gerardo Chowell|Christopher M. Kribs-Zaleta|Niyamat Ali Siddiqui|Narendra Kumar|Pradeep Das
Transmission dynamics and underreporting of Kala-azar in the Indian state of Bihar
Cancer Prevention Institute of California|The University of Texas at Arlington|Arizona State University|Arizona State University|Santa Fe Institute|Arizona State University|The University of Texas at Arlington|Rajendra Memorial Research Institute of Medical Sciences|Rajendra Memorial Research Institute of Medical Sciences|Rajendra Memorial Research Institute of Medical Sciences
kalaazar indian visceral leishmaniasis vectorborne infectious disease affecting communities tropical subtropical areas world bihar state india one highest prevalence mortality reported levels kalaazar yet magnitude problem difficult assess cases handled private health providers required report ministry health impact underreporting using districtlevel reported incidence data state bihar main goal manuscript derive expressions compute estimates kalaazars reproduction numbers indirect measure disease prevalence levels underreporting 21 affected districts bihar average reproduction number number secondary cases generated per infective estimates bihar range 13 2003 21 2005 districts estimates mean values lower one model estimates using available data modelderived expression show proportion underreported cases declined average 88 2003 73 2005 however eight districts 2003 five districts 2005 90 levels underreporting model estimates used generate underreporting adjusted incidence rates analysis finds reported data misidentify four eight 2003 three nine 2005 districts classified highrisk fact seven 2003 five 2005 affected kalaazar districts classified lowrisk reported incidence data used