Socio-economic and behavioural risk factors of visceral leishmaniasis in the East Champaran district of Bihar

Navin Kumar, T. B. Singh, L. P. Meena


Background: Visceral leishmaniasis is a chronic and potentially fatal parasitic disease of the viscera which affect the organs due to infection by Leishmania donovani. Visceral Leismaniasis, also known as Kala-Azar (KA) in the Indian subcontinent. The worldwide incidence is estimated to be between 146,700 and 282,800 cases per year. In India, it is endemic in the states Bihar and it contains more than 90 % of the cases of VL.In this region, Leishmania donovani is the only species causing VL. Objective: To find out the socio-economic and behavioural risk factors of VL in East Champaran district of Bihar.

Methods: A case-control study was conducted to understand the socio-economic and behavioural risk factors associated with VL in areas of East Champaran district of Bihar, India. A total of 100 VL cases and 100 healthy controls selected randomly from the neighbourhoods of cases were included in the study.

Results: The risk factors identified were showed that presence of a granary inside houses (P=0.000), sunlight inside the living room (P=0.000), banana trees near the houses (P=0.003), presence of domestic animal in the house (P=0.044), people sleep near the animal (P=0.000) and drainage system (P=0.000) were risk factors of VL.

Conclusions: These results will be useful for further improvement in the VL control programs for intervention strategies in respect of separate granary house other than the living house, presence of sunlight inside the living rooms, banana trees far from the houses, separate domestic shelter for reducing transmission and incidence of this disease.


Visceral leishmaniasis, East Champaran, Case-control, Risk factor

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"Leishmaniasis Fact sheet N°375". World Health Organization. January 2014. Retrieved 17 February 2014.

Mauricio IL, Stothard JR, Miles MA. The strange case of Leishmania chagasi. Parasitology Today. 2000;16:188–90.

Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE. 2012;7(5):E35671.

Stauch A, Sarkar RR, Picado A, Ostyn B, Sunder S, Rijal S, et al. Visceral leishmaniasis in the Indian subcontinent: modelling epidemiology and control. PLoS Negl Trop Dis. 2011;5(11):e1405.

Perry D, Dixon K, Garlapati R, Gendernalik A, Poche D, Poche R. Visceral Leishmaniasis Prevalence and Associated Risk Factors in the Saran District of Bihar, India, from 2009 to July of 2011. Am J Trop Med Hygiene. 2013;88(4):778–84.

Bern C, Chowdhury R. The epidemiology of visceral leishmaniasis in Bangladesh: prospects for improved control. Indian J Med Res. 2006;123(3):275-88.

Joshi A, Narain JP, Prasittisuk C, Bhatia R, Hashim G, Jorge A, et al. Can visceral leishmaniasis be eliminated from Asia? J Vector Borne Dis. 2008;45(2):105-11.

A consultation meeting on indicators for Kala-azar elimination organized at SEARO office, New-Delhi in June 09.

Brain storming session meeting at National Vector Borne Diseases Control Programme office, New-Delhi on 19th Jan. 2011.

Thakur CP. Socio-economies of visceral leishmaniasis in Bihar (India). Trans R Soc Trop Med Hyg. 2000;94:156–7.

Dhiman RC, Sen AB. Epidemiology of Kala-azar in rural Bihar (India) using village as a component unit of study. Indian J Med Res. 1991;93:155–60.

Dinesh DS, Dhiman RC, Ranjan A, Prasad SK, Kishore K, Kar SK, The cross-sectional epidemiological studies on Kala-azar around Patna City in Bihar. Indian J Parasitol. 1994;18:143–7.

Singh S, Sivakumar R. Challenges and new discoveries in the treatment of leishmaniasis. J Infect Chemother. 2004;10:307–15.

Ross R. Further notes on Leishman’s bodies. Br Med J. 1903;2(2239):1401.

Thakur CP, Sinha KP, Gupta AK, Kumar SC. Study of the outbreak of kala-azar epidemic in Bihar. J Assoc Physicians India. 1978;26(6):511-8.

Aikat BK, Mohanty D, Pathania AG. Hematological investigation in kala-azar in Bihar. Indian Jour Med Res. 1979;70:571-82.

Thakur CP. Epidemiological, clinical and therapeutic features of Bihar kala-azar (including post kala-azar dermal leishmaniasis). Trans R Soc Trop Med Hyg. 1984;78:390-1.

Thakur CP. Socio-economics of Visceral Leishmaniasis in Bihar (India). Trans R Soc Trop Med Hyg. 2000;94(2):156-7.

Sudhakar S, Srinivas T, Palit A, Kar SK, Battacharya SK. Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in parts of Bihar state, India: an RS and GIS approach. J Vect Borne Dis. 2006;43:115-22.