4.6 Article

Mathematical modelling of the use of insecticide-treated nets for elimination of visceral leishmaniasis in Bihar, India

Journal

ROYAL SOCIETY OPEN SCIENCE
Volume 8, Issue 6, Pages -

Publisher

ROYAL SOC
DOI: 10.1098/rsos.201960

Keywords

Kala-azar; post kala-azar dermal leishmaniasis; asymptomatic transmission; parameter estimation; vector-borne diseases

Funding

  1. VCU REU program in mathematics - National Security Agency [H98230-20-1-0011]

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This study used mathematical modeling to investigate the impact of insecticide-treated nets (ITNs) on the prevention of visceral leishmaniasis (VL). The results suggest that in order to eliminate VL, ITN usage would have to stay above 96%, higher than the 91% observed at the end of a large trial in Nepal and India. Additionally, the model indicates that asymptomatic individuals play a crucial role in VL transmission.
Visceral leishmaniasis (VL) is a deadly neglected tropical disease caused by a parasite Leishmania donovani and spread by female sand flies Phlebotomus argentipes. There is conflicting evidence regarding the role of insecticide-treated nets (ITNs) on the prevention of VL. Numerous studies demonstrated the effectiveness of ITNs. However, KalaNet, a large trial in Nepal and India did not support those findings. The purpose of this paper is to gain insight into the situation by mathematical modelling. We expand a mathematical model of VL transmission based on the KalaNet trial and incorporate the use of ITNs explicitly into the model. One of the major contributions of this work is that we calibrate the model based on the available epidemiological data, generally independent of the KalaNet trial. We validate the model on data collected during the KalaNet trial. We conclude that in order to eliminate VL, the ITN usage would have to stay above 96%. This is higher than the 91% ITNs use at the end of the trial which may explain why the trial did not show a positive effect from ITNs. At the same time, our model indicates that asymptomatic individuals play a crucial role in VL transmission.

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