Surendra Uranw|Epco Hasker|Lalita Roy|Filip Meheus|Murari Lal Das|Narayan Bhattarai|Suman Rijal|Marleen Boelaert
An outbreak investigation of visceral leishmaniasis among residents of Dharan town, eastern Nepal, evidence for urban transmission of Leishmania donovani
B.P. Koirala Institute of Health Sciences|Instituut voor Tropische Geneeskunde|B.P. Koirala Institute of Health Sciences|Instituut voor Tropische Geneeskunde|B.P. Koirala Institute of Health Sciences|B.P. Koirala Institute of Health Sciences|B.P. Koirala Institute of Health Sciences|Instituut voor Tropische Geneeskunde
visceral leishmaniasis vl predominantly rural disease common low lands eastern nepal since 1997 vl cases also reported among residents city dharan main research objective find whether local transmission vl inside city conducted outbreak investigation including casecontrol study cases urban residents treated vl 2000 2008 bp koirala institute health sciences university hospital city case selected four random controls history previous vl frequencymatched age cases controls subjected structured interview main exposures interest potential confounders binominal multilevel model used analyze data also collected entomological data neighborhoods city enrolled 115 vl patients 448 controls cases strongly clustered 70 residing 3 19 neighborhoods found strong association socioeconomic status poorest risk housing risk factor independent socioeconomic status risk living thatched houses without windows sleeping upstairs sleeping bed strongly protective 008 025 respectively proximity case strong risk factor 379 sand flies captured neighborhoods collections several neighborhoods presence l donovani could demonstrated pcr evidence found study consistent transmission anthroponotic vl within city vector p argentipes parasite l donovani identified inside town findings highly relevant policy makers vl endemic areas appropriate surveillance disease control measures must adopted rural areas urban areas well