{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T20:05:06Z","timestamp":1751400306223},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,5]]},"abstract":"<jats:p>In the Indian subcontinent, visceral leishmaniasis (VL) has a strongly clustered distribution. The \u201cindex case approach\u201d is promoted both for active case finding and indoor residual spraying (IRS). Uncertainty exists about the optimal radius. Buffer zones of 50\u201375 m around incident cases have been suggested for active case finding, for IRS the recommendation is to cover a radius of 500 m. Our aim was to establish optimal target areas both for IRS and for (re)active case finding. We plotted incident VL cases on a map per 6-month period (January\u2013June or July\u2013December) and drew buffers of 0 (same household), 50, 75, 100, 200, 300, 400, and 500 m around these cases. We then recorded total population and numbers of VL cases diagnosed over the next 6-month period in each of these buffers and beyond. We calculated incidence rate ratios (IRRs) using the population at more than 500 m from any case as reference category. There was a very strong degree of spatial clustering of VL with IRRs ranging from 45.2 (23.8\u201385.6) for those living in the same households to 14.6 (10.1\u201321.2) for those living within 75 m of a case diagnosed, during the previous period. Up to 500 m the IRR was still five times higher than that of the reference category. Our findings corroborate the rationale of screening not just household contacts but also those living within a perimeter of 50\u201375 m from an index case. For IRS, covering a perimeter of 500 m, appears to be a rational choice.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0448","type":"journal-article","created":{"date-parts":[[2018,10,9]],"date-time":"2018-10-09T07:02:37Z","timestamp":1539068557000},"page":"1555-1561","source":"Crossref","is-referenced-by-count":10,"title":["Visceral Leishmaniasis in the Muzaffapur Demographic Surveillance Site: A Spatiotemporal Analysis"],"prefix":"10.4269","volume":"99","author":[{"given":"Epco","family":"Hasker","sequence":"first","affiliation":[{"name":"Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paritosh","family":"Malaviya","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristien","family":"Cloots","sequence":"additional","affiliation":[{"name":"Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Picado","sequence":"additional","affiliation":[{"name":"Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland;"},{"name":"ISGlobal, Hospital Cl\u00ednic, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Om Prakash","family":"Singh","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sangeeta","family":"Kansal","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marleen","family":"Boelaert","sequence":"additional","affiliation":[{"name":"Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shyam","family":"Sundar","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Mem Inst Oswaldo Cruz","first-page":"609","article-title":"Delimitation of kala-azar risk areas in the district of Vaishali in Bihar (India) using a geo-environmental approach","volume":"107","author":"Bhunia","year":"2012"},{"key":"b2","series-title":"Nat Rev Microbiol","first-page":"873","article-title":"Visceral leishmaniasis: what are the needs for diagnosis, treatment and control?","volume":"5","author":"Chappuis","year":"2007"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e599","article-title":"Of cattle, sand flies and men: a systematic review of risk factor analyses for south Asian visceral leishmaniasis and implications for 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USA","first-page":"8573","article-title":"DDT-based indoor residual spraying suboptimal for visceral leishmaniasis elimination in India","volume":"112","author":"Coleman","year":"2015"},{"issue":"(Suppl 1)","key":"b18","series-title":"J Vector Ecol","first-page":"S106","article-title":"Bionomics of Phlebotomine sand flies from three villages in Bihar, India","volume":"36","author":"Poche","year":"2011"},{"key":"b19","series-title":"Am J Trop Med Hyg","first-page":"778","article-title":"Visceral leishmaniasis prevalence and associated risk factors in the saran district of Bihar, India, from 2009 to July of 2011","volume":"88","author":"Perry","year":"2013"}],"container-title":["The American Journal of Tropical Medicine and 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