An Opinion based on a Retrospective Study on Vector Management for the Elimination of Visceral Leishmaniasis and its Sustenance
Background: Visceral leishmaniasis (Kala-azar, VL) is a vector-borne illness that affects people all over the world. Indoor Residual Spray (IRS) has been recognised as a tool for eliminating the illness. In the context of Kala-azar elimination, it is critical to address evidence-based studies on IRS success and failure.
Methodology: For the literature search, the Internet was used. The following websites were visited: PubMed, Google Search Engine, ResearchGate, NVBDCP sites, and WHO/TDR sites. We utilised keywords like leishmaniasis vector, indoor residual spray, eradication of visceral leishmaniasis, and sand fly ecology in our search, and we also visited the library of ICMR-RMRI for the journals which we could not find on the internet.
Result: The success of IRS may be shown in the progress made in controlling kala-azar in Assam via vector control. This accomplishment, however, could not be duplicated in Bihar. We looked at all of the studies that dealt with insecticides and vector control. In addition, policies and papers produced by the Indian government and the World Health Organization (WHO) from time to time were included. Suboptimal pesticide usage, a lack of effective IRS M&E, and the use of resistance insecticides have all been concerns in vector control, resulting in failure to meet elimination objectives.
Conclusion: It is suggested that strong Monitoring and Evaluation (M&E) is needed particularly during the low transmission period. Restrictive use of insecticide associated with other control measures will be helpful. Determination of infectivity rate in vector and accordingly application of intervention will stop the unscrupulous use of the insecticide.
How to cite this article:
Kumar V, Rama A, Sharma SN. An Opinion based on a Retrospective Study on Vector Management for the Elimination of Visceral Leishmaniasis and its Sustenance. J Commun Dis. 2022;54(2):1-11.
World Health Organization [Internet]. The Global Health Observatory,Leishmaniasis;2021[cited 2021 Oct 15].
World Health Organization [Internet].The Leishmaniasis; 2021 [cited 2021 Oct 15]. Available from: https://www.
Kumar A, Saurabh S, Jamil S, Kumar V. Intensely clustered outbreak of visceral leishmaniasis (kalaazar) in a setting of seasonal migration in a village of Bihar, India. BMC Infect Dis. 2020;20(1):10. [PubMed]
Priyamvada K, Bindroo J, Sharma MP, Chapman LA, Dubey P, Mahapatra T, Hightower AW, Bern C, Srikantiah
S. Visceralleishmaniasis outbreaks in Bihar: communitylevel investigations in the context of elimination of
kala-azar as a public health problem. Parasit Vectors. 2021;14(1):52. [PubMed] [Google Scholar]
Guidelines by the Directorate National vector Borne Disease Control Programme (NVBDCP) [Internet].
Accelerated Plan for the Kala-azar elimination 2017;[cited 2021 Jul 10]. Available from: https://
Coleman M, Foster GM, Deb R, Singh RP, Ismail HM, ShivamP, Ghosh AK, Dunkley S, Kumar V, Coleman
M, Hemingway J, Paine MJ, Das P. DDT-based indoor residual spraying suboptimal for visceral leishmaniasis
elimination in India. Proc Natl Acad Sci USA. 2015;112(28):8573-8. [PubMed] [Google Scholar]
Poché DM, Garlapati RB, Mukherjee S, Torres-Poché Z, Hasker E, Rahman T, Bharti A, Tripathi VP, Prakash S,
Chaubey R, Poché RM. Bionomics of Phlebotomusargen tipesin villages in Bihar, India with insights into efficacy
of IRS-based control measures. PLoS Negl Trop Dis. 2018;12(1):e0006168. [PubMed] [Google Scholar]
Muniaraj M. The lost hope of elimination of Kala-azar (visceral leishmaniasis) by 2010 and cyclic occurrence
of its outbreak in India, blame falls on vector control practices or co-infection with human immunodeficiency
virus or therapeutic modalities? Trop Parasitol. 2014 Jan;4(1):10-9. [PubMed] [Google Scholar]
Quinonez CA, Runge-Ranzinger S, Rahman KM, Horstick O. Effectiveness of vector controlmethods for the
control of cutaneous and visceral leismaniasis:a metareview. PLoS Negl Trop Dis. 2021;15(5):e0009309.
[PubMed] [Google Scholar]
Verghese T, Rahman SJ. A critical appraisal of dynamics of kala-azar transmission vis-à-vis vector control measures in India. Proceeding of workshops on Entomological and Vector Control Aspects of Kala-azar. Delhi: National Institute of Communicable Diseases; 1993.
Kaul SM, Sharma RS, Borgohain BK, Das NS, Verghese T. Absence of Phlebotomusargentipes Ann & Brun.
(Diptera: Psychodidae) the vector of Indian kalaazar from Kamrup district, Assam. J Commun Dis.
;26(2):68-74. [PubMed] [Google Scholar]
Khan AM, Dutta P, Khan SA, Baruah SK, Raja D, Khound K, Mahanta J. Kala-azar and post-Kala-azar
dermal leishmaniasis, Assam, India. EmergInfect Dis. 2014;20(3):487-9. [PubMed] [Google Scholar]
Thakur CP. A new strategy for elimination of kala-azar from rural Bihar. Indian J Med Res. 2007;126(5):447-
[PubMed] [Google Scholar]
Ghosh KN, Bhattacharya A, Ghosh TN. Blood meal analysis of Phlebotomusargentipes in eight districts
of West Bengal. J Commun Dis. 1990;22(1):67-71. [PubMed] [Google Scholar]
Mukhopadhyay AK, Chakravarty AK. Bloodmeal preference of Phlebotomusargentipes & Ph. papatasi
of north Bihar, India. Indian J Med Res. 1987;86:475-80. [Google Scholar]
KishoreK, Kumar V, Kesari S, Dinesh DS, Kumar AJ, Das P, Bhattacharya SK. Vector control in leishmaniasis.
Indian J Med Res. 2006 Mar;123(3):467-72. [PubMed] [Google Scholar]
Picado A, Das ML, Kumar V, Dinesh DS, Rijal S, Singh SP, Das P, Coosemans M, Boelaert M, Davies C.
Phlebotomusargentipes seasonal patterns in India and Nepal. J Med Entomol. 2010;47(2):283-6. [PubMed]
Kumar V, Kishore K, Bhattacharya SK. Control Strategy of Kala-azar in the light of of study of transmission
period of disease. J Lab Med. 2002;3:58.
Palit A, Kishore K, Kesari S, Kumar V, Dinesh DS, Kar SK. Effectivity and sustenance of DDT as anti kala-azar
vector measure. Symposium onUN Brahamchari and perspective of Kala-azar research. Calcutta: National
Institute of Chemical Biology; 1995. p.26.
Young TC. Fourteen years’ experience with kalaazar work in Assam. Trans Royal Soc Trop Med Hyg.
;18(3):81-97. [Google Scholar]
Sen Gupta PC. A report on kala-azar in Assam. Ind Med Gaz. 1951;86(6):266-71. [PubMed] [Google Scholar]
Bora D. Epidemiology of visceral leishmaniasis in India. Natl Med J India. 1999;12(2):62-8. [PubMed] [Google
Khan AM, Pandey K, Kumar V, Dutta P, Das P, Mahanta J. Sample survey for indigenous cases of kala-azar
in Assam by rk39 dipstick test. Indian J Med Res. 2009;129(3):327-28. [PubMed] [Google Scholar]
Desjeux P. Information on the epidemiology and control of the leishmaniasis by country or territory. World
Health Organization; 1991.
Lewis DJ. Phlebotomine sandflies (Diptera: Psychodidae) from the Oriental Region. Systemat Entomol.
;12(2):163-80. [Google Scholar]
National Vector Borne Disease Control Programme. Joint Monitoring Mission Report. NVBDCP;2007.
Joshi AB, Das ML, Akhter S, Chowdhury R, Mondal D,Kumar V, Das P, Kroeger A, Boelaert M, Petzold M.
Chemical and environmental vector control as a contribution to the elimination of visceral leishmaniasis
on the Indian subcontinent: cluster randomized controlled trials in Bangladesh, India and Nepal. BMC
Med. 2009;7:54. [PubMed] [Google Scholar]
World Health Organization. Monitoring and evaluation tool kit for indoor residual spraying Kala-azar elimination in Bangladesh, India and Nepal. WHO; 2010.
National Vector Borne Disease Control Programme. Guidelineson vector control in Kala-azar elimination.
Progress of National Kala-azar Elimination Programme. Report of National Advisory Committee (NAC)
constituted by the Ministry of Health & Family Welfare.
Kumar V, Kesari S,Dinesh DS, Tiwari AK, Kumar AJ, Kumar R, Singh VP, Das P. A report on the indoor residual
spraying (IRS) in the control of Phlebotomusargentipes, the vector of visceral leishmaniasis in Bihar (India):
an initiative towards total elimination targeting 2015 (Series-1). J Vector Borne Dis. 2009 Sep;46(3):225-9.
[PubMed] [Google Scholar]
Hati AK, Sur S, De N, Dwivedi HN, Bhattacharyya J, Mukherjee H, Chandra G. Longitudinal study on
distribution of Phlebotomusargentipes sandflies at different heights in cattleshed. Indian J Med Res.
;93:388-90. [PubMed] [Google Scholar]
Srinivasan R, Jambulingam P, Kumar NP, Selvakumar M, Edwin B, Kumar TD. Temporal distribution and behaviour of sand flies (Diptera: Psychodidae) in a cutaneous leishmaniasis focus of the KaniTribesettlements in the Western Ghats, India. Acta Trop. 2015;148:147-55. [PubMed] [Google Scholar]
Huda MM, Kumar V, Das ML, Ghosh D, Priyanka J, Das P, Alim A, Matlashewski G, Kroeger A, Alfonso-Sierra E,
Mondal D. Entomological efficacy of durable wall lining with reduced wall surface coverage for strengthening
visceral leishmaniasis vector control in Bangladesh, India and Nepal. BMC Infect Dis. 2016;16(1):539.
[PubMed] [Google Scholar]
Kumar V, Rama A, Mandal R, Das P. Understanding behavioural temperament of Phlebotomusargentipes
under the influence of DDT-IRS versus SP-IRS for scoping new approaches for maximum control overthe VL-Vector population in Bihar. Int J Trop Dis Health. 2019;40(1):1-11. [Google Scholar]
Kumar A, Sabesan S, Srinivasan R. Review of vector control strategies towards Kala-azar elimination
activities under the National Vector Borne Disease Control Programme. ICMR-VCRC, Puducherry; 2019.
WHO [Internet].Independent assessment of the Kalaazar elimination programme India; 2019 [cited 2020 Sep 1]. Available from: https://www.who.int/publications/i/item/9789290227960
Mukhopadhyay AK, Saxena NB, Narsimham MV. Susceptibility status of Phlebotomusargentipes to DDT
in some kala-azar endemic areas of Bihar (India). Indian J Med Res. 1990;91:458-60. [PubMed]
Joshi RD, Rai RN. Impact of DDT spraying on populations ofP. argentipesandP. papatasiin Varanasi district, Uttar Pradesh. J Commun Dis.1994;26(1):56-8. [PubMed] [Google Scholar]
Mukhopadhyay AK, Hati AK, Chakraborty S, Saxena NB. Effect of DDT on Phlebotomuss and flies in kalaazar endemic foci in West Bengal. J Commun Dis. 1996;28(3):171-5. [PubMed] [Google Scholar]
Basak B, Kundu M, Tandon N. Observation on host preference of Phlebotomusargentipes in district
South-24-Parganas, West Bengal, India. J Commun Dis. 1995;27(2):122-3. [PubMed] [Google Scholar]
Dhiman RC, Raghavendra K, Kumar V, Kesari S, Kishore K. Susceptibility status of Phlebotomusargentipes to
insecticides in districts Vaishaii and Patna (Bihar). J Commun Dis. 2003;35(1):49-51. [PubMed] [Google
Kishore K, Kumar V, Kesari S, Bhattacharya SK, Das P. Susceptibility of Phlebotomusargentipes against DDT
in endemic districts of North Bihar, India. J Commun Dis. 2004;36(1):41-4. [PubMed] [Google Scholar]
Dinesh DS, Das ML, Picado A, Roy L, Rijal S, Singh SP, Das P, Boelaert M, Coosemans M. Insecticide susceptibility of Phlebotomusargentipesin visceral leishmaniasis endemic districts in India and Nepal. PLoSNegl Trop Dis. 2010;4(10):e859. [PubMed] [Google Scholar]
Singh R, Kumar P. Susceptibility of the sand fly Phlebotomusargentipes Annandale and Brunetti
(Diptera: Psychodidae) to insecticides in endemic areas of visceral leishmaniasis in Bihar, India. Jpn J Infect Dis.
;68(1):33-7. [PubMed] [Google Scholar]
Kumar V, Shankar L, Kesari S, Bhunia GS, Dinesh DS, Mandal R, Das P. Insecticide susceptibility of
Phlebotomusargentipes & assessment of vector control in two districts of West Bengal, India. Indian J Med Res.
;142(2):211. [PubMed] [Google Scholar]
Rama A, Kesari S, Das P, Kumar V. Studying DDT susceptibility at discriminating time intervals focusing
on maximum limit of exposure time survived by DDT resistant Phlebotomusargentipes (Diptera:
Psychodidae): an investigative report. Jpn J Infect Dis. 2017;70(4):437-41. [PubMed] [Google Scholar]
Dhiman RC, Yadav RS. Insecticide resistance in phlebotomine sandflies in Southeast Asia with
emphasis on the Indian subcontinent. Infect Dis Poverty. 2016;5(1):106. [PubMed] [Google Scholar]
Selvakumar M, Srinivasan R. Susceptibility status of Phlebotomusargentipes to DDT and deltamentrinin
a focus of cutaneous leishmaniasis in Kanitribes settlement of the Western Ghats in Kerala, India. Int J
Curr Res. 2015;7(8);19564-6. [Google Scholar]
Kumar V, Kesari S, Chowdhury R, Kumar S, Sinha G, Hussain S, Huda MM, Kroeger A, Das P. User friendliness,
efficiency & spray quality of stirrup pumps versus hand compression pumps for indoor residual spraying. Indian
J Med Res. 2013;138(2):239-43. [PubMed] [Google Scholar]
World Health Organization. Test procedures for insecticide resistance monitoring in malaria vector
mosquitoes. 2nd ed. Global Malaria Programme; 2005. [Google Scholar]
Chowdhury R, Huda MM, Kumar V, Das P, Joshi AB, Banjara MR, Akhter S, Kroeger A, Krishnakumari B,
Petzold M, Mondal D, Das ML. The Indian and Nepalese programmes of indoor residual spraying for the
elimination of visceral leishmaniasis: performance and effectiveness. Ann Trop Med Parasitol. 2011;105(1):31.
[PubMed] [Google Scholar]
Ismail HM, Kumar V, Singh RP, Williams C, Shivam P, Ghosh A, Deb R, Foster GM, Hemingway J, Coleman M,
Coleman M, Das P, Paine MJ. Development of a Simple Dipstick Assay for operational monitoring of DDT.
PLoSNegl Trop Dis. 2016;10(1):e0004324. [PubMed] [Google Scholar]
Huda MM, Mondal D, Kumar V, Das P, Sharma SN, Das ML, Roy L, Gurung CK, Banjara MR, Akhter S,
Maheswary NP, Kroeger A, Chowdhury R. Toolkit for monitoring and evaluation of indoor residual
spraying for visceral leishmaniasis control in the Indian subcontinent: application and results. J Trop Med.
;2011:876742. [PubMed] [Google Scholar]
Deb R, Singh RP, Mishra PK, Hitchins L, Reid E, Barwa AM, Patra D, Das C, SuklaI, Srivastava AK, Raj S, Mishra
S, Swain M, Mondal S, Mandal U, Foster GM, Trett A, Garrod G, McKenzie L, Ali A, MorchanK, Chaudhuri I,
Roy N, Gill NK, Singh C, Agarwal N, Sharma S, Stanton MC, Hemingway J, SrikantiahS, Coleman M. Impact of
IRS: four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme.
PLoSNegl Trop Dis. 2021 Aug 9;15(8):e0009101. [PubMed] [Google Scholar]
Palit A, Chowdhury DK, Hati AK. Preliminary observationson dispersionof Phlebotomusargentipes, Annandale and Brunette (Psychodidae, Diptera). Indian J Parasitol. 1988;12(1):15-6.
Kumar V, Mandal R, Das S, Kesari S, Dinesh DS, Pandey K, Das VR, Topno RK, Sharma MP, Dasgupta RK, Das P.
Kala-azar elimination in a highly-endemic district of Bihar, India: a success story. PLoS Negl Trop Dis. 2020
May 4;14(5):e0008254. [PubMed] [Google Scholar]
ICMR-RMRI Report [unpublished].
Mandal R, Kumar V, Kesari S, Das P. Assessing the combined effects of household type and insecticide
effectiveness for kala-azar vector control using indoor residual spraying: a case study from North Bihar, India.
Parasit Vectors. 2009;12(1):409. [PubMed] [Google Scholar]
Rutte EA, Coffeng LE, Bontje DM, Hasker EC, Postigo JA, Argaw D, Boelaert MC, Vlas SJ. Feasibility of eliminating visceral leishmaniasis from the Indian subcontinent: explorations with a set of deterministic age-structured transmission models.Parasit Vectors. 2016;9:24. [PubMed] [Google Scholar]
Kumar V, Rama A, Mishra PS, Siddiqui NA, Singh RP, Dasgupta RK, Kroeger A, Das P. Investigating associative
impact of indoor residual spray and insecticide treated nets for minimizing visceral leishmaniasis vector
population in Bihar (India). Int J Trop Dis Health. 2017;23(4):1-15. [Google Scholar]
Bath D, Cook J, Gover J, Mathebula P, Morris N, Hlongwana K, Raman J, Seocharan I, Zitha A, Zitha
M, Mabuza A, Mbokazi F, Machaba E, Mabunda E, Jamesboy E, Biggs J, Drakeley C, Moonasar D, Maharaj
R, Coetzee M, Pitt C, Kleinschmidt I. Effectiveness and cost-effectiveness of reactive, targeted indoor residual
spraying for malaria control in low-transmission settings: a cluster-randomised non-inferiority trial in South
Africa. Lancet. 2021;397(10276):816-27. [PubMed] [Google Scholar]
Gomes B, Purkait B, Deb RM, Rama A, Singh RP, Foster GM, Coleman M, Kumar V, Paine M, Das P, Weetman
D.Knockdown resistance mutations predict DDT resistance and pyrethroid tolerance in the visceral
leishmaniasis vector Phlebotomusargentipes. PLoS Negl Trop Dis. 2017;11(4):e0005504. [PubMed] [Google
Trial of alternative insecticides for sand fly (Phlebotomus argentipes) control by IRS in India. Kala CORE Project. IRR Project ID:331490AS01, 2016-19.
Russell TL, Morgan JC, Ismail H, Kaur H, Eggelte T, Oladepo F, Amon J, Hemingway J, Iata H, Paine MJ. Evaluating the feasibility of using insecticide quantification kits (IQK) for estimating cyanopyrethroid levels for indoor residual spraying in Vanuatu. Malar J. 2014;13:178. [PubMed] [Google Scholar]
Cameron M, Acosta-Serrano A, Bern C, Boelaert M, den Boer M, Burza S, Chapman LA, Chaskopoulou
A, Coleman M, Courtenay O, Croft S, Das P, Dilger E, Foster G, Garlapati R, Haines L, Harris A, Hemingway
J, Hollingsworth TD, Jervis S, Medley G, Miles M, Paine M, Picado A, Poché R, Ready P, Rogers M, Rowland
M, Sundar S, de Vlas SJ, Weetman D. Understanding the transmission dynamics ofLeishmaniadonovanito
provide robust evidence for interventions to eliminate visceral leishmaniasis in Bihar, India.Parasit Vectors.
;9:25. [PubMed] [Google Scholar]
Chowdhury R, Chowdhury V, Faria S, Islam S, Maheswary NP, Akhter S, Islam MS, Dash AP, Kroeger A, Banu
Q. Indoor residual spraying for Kala-azar control in Bangladesh: a continuing challenge. PLoS Negl Trop
Dis. 2018;12(10):e0006846. [PubMed] [Google Scholar]
World Health Organisation. Expert Consultation on Kala-azar Vector Control. Central University of Tamil
Nadu (CUTN); 2016.
World Health Organization. Indoor residual spraying: an operational manual for indoor residual spraying (IRS) for malaria transmission control and elimination. 2nd ed. WHO; 2015. [Google Scholar]
Copyright (c) 2022 Author's
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.