{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:13:51Z","timestamp":1790806431655,"version":"4.1.0"},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The aim of this study was to explore epidemiological, serological, entomological, and social aspects of visceral leishmaniasis (VL) in new foci in Nepal. The study was conducted in 11 villages of five districts that had been previously free of VL but that reported new cases between 2019 and 2021. We screened 1,288 inhabitants using rK39 tests and investigated the epidemiological and clinical characteristics of 12 recent VL cases. A total of 182 community members were interviewed about knowledge, attitude, and practices regarding VL. They then underwent an awareness training; 40 of them had a second interview at 6 months to assess the training impact. Vector surveys were conducted in six houses per village to assess sandfly density and infection rates. The prevalence of VL infection was 0.5% and 3.2% among screened populations in Dolpa and Kavre districts, respectively, while the other districts had no rK39-positive cases. No association between travel history and VL infection was found. <jats:italic>Phlebotomus argentipes<\/jats:italic> sandflies were collected in three districts at high altitudes (from 1,084 to 4,450\u2009m). None of the sandflies captured had <jats:italic>Leishmania donovani<\/jats:italic> DNA. People in new foci were not aware of VL symptoms, vectors, or preventive measures. The training significantly improved their knowledge and practice in seeking medical care in case of illness. The epidemiological, serological, and entomological investigations suggest indigenous focal transmission of VL. An integrated package of strategic interventions should be implemented by the national VL elimination program in districts with new VL foci.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0373","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T18:08:27Z","timestamp":1701108507000},"page":"44-51","source":"Crossref","is-referenced-by-count":6,"title":["Epidemiological, Serological, and Entomological Investigation of New Visceral Leishmaniasis Foci in Nepal"],"prefix":"10.4269","volume":"110","author":[{"given":"Anand Ballabh","family":"Joshi","sequence":"first","affiliation":[{"name":"Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha Raj","family":"Banjara","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal;"},{"name":"UNICEF\/UNDP\/World Bank\/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murari Lal","family":"Das","sequence":"additional","affiliation":[{"name":"Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragyan","family":"Ghale","sequence":"additional","affiliation":[{"name":"Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna Raj","family":"Pant","sequence":"additional","affiliation":[{"name":"Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uttam Raj","family":"Pyakurel","sequence":"additional","affiliation":[{"name":"Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokarna","family":"Dahal","sequence":"additional","affiliation":[{"name":"Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna Prasad","family":"Paudel","sequence":"additional","affiliation":[{"name":"Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuman Lal","family":"Das","sequence":"additional","affiliation":[{"name":"Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Kroeger","sequence":"additional","affiliation":[{"name":"Centre for Medicine and Society, Albert-Ludwigs-University, Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Aseffa","sequence":"additional","affiliation":[{"name":"UNICEF\/UNDP\/World Bank\/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Ending the Neglect To Attain the Sustainable Development Goals: A Road Map for Neglected Tropical Diseases 2021\u20132030","year":"2020"},{"key":"b2","series-title":"BMJ","first-page":"k5224","article-title":"Eliminating visceral leishmaniasis in South Asia: the road ahead","volume":"364","author":"Rijal","year":"2019"},{"key":"b3","series-title":"Annual Report 2076\/2077","year":"2020"},{"key":"b4","series-title":"National Guideline on Kala-Azar Elimination Program (updated)","year":"2019"},{"key":"b5","series-title":"PLoS Negl Trop Dis","first-page":"e0005889","article-title":"Towards elimination of visceral leishmaniasis in the Indian subcontinent\u2014translating research to practice to public health","volume":"11","author":"Hirve","year":"2017"},{"key":"b6","series-title":"Pathog Glob Health","first-page":"87","article-title":"Implication of vector characteristics of Phlebotomus argentipes in the kala-azar elimination programme in the Indian sub-continent","volume":"110","author":"Chowdhury","year":"2016"},{"key":"b7","series-title":"Am J Trop Med Hyg","first-page":"349","article-title":"Response to visceral leishmaniasis cases through active case detection and vector control in low endemic non-programme districts of Nepal","volume":"107","author":"Banjara","year":"2022"},{"key":"b8","series-title":"J Nepal Health Res Counc","first-page":"194","article-title":"Investigation of visceral leishmaniasis transmission in selected districts of Nepal","volume":"20","author":"Basnyat","year":"2022"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"107","article-title":"Case report: expansion of visceral leishmaniasis to the western hilly part of Nepal","volume":"84","author":"Pandey","year":"2011"},{"key":"b10","series-title":"Clin Case Rep","first-page":"e05817","article-title":"Visceral leishmaniasis in non-endemic rural hilly region of Nepal: a case report","volume":"10","author":"Belbase","year":"2022"},{"key":"b11","series-title":"BMC Infect Dis","first-page":"444","article-title":"Molecular evidence supports the expansion of visceral leishmaniasis towards non-program districts of Nepal","volume":"19","author":"Shrestha","year":"2019"},{"key":"b12","series-title":"PLoS Negl Trop Dis","first-page":"e0003966","article-title":"Transmission of Leishmania donovani in the hills of Eastern Nepal, an outbreak investigation in Okhaldhunga and Bhojpur districts","volume":"9","author":"Ostyn","year":"2015"},{"key":"b13","series-title":"Lancet Glob Health","first-page":"e237","article-title":"Impact of the visceral leishmaniasis elimination initiative on Leishmania donovani transmission in Nepal: a 10-year repeat survey","volume":"8","author":"Cloots","year":"2020"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"227","article-title":"A series of case reports of autochthonous visceral leishmaniasis, mostly in non-endemic hilly areas of Nepal","volume":"88","author":"Pun","year":"2013"},{"key":"b15","series-title":"J Trop Pediatr","first-page":"104","article-title":"Changing epidemiology: a new focus of kala-azar at high-altitude Garhwal region of North India","volume":"63","author":"Bhat","year":"2017"},{"key":"b16","series-title":"Infect Drug Resist","first-page":"881","article-title":"Incidence of mortality and its predictors among adult visceral leishmaniasis patients at the University of Gondar Hospital: a retrospective cohort study","volume":"13","author":"Yeshaw","year":"2020"},{"key":"b17","series-title":"PLoS Negl Trop Dis","first-page":"e0008132","article-title":"Housing structure including the surrounding 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of sandflies collected in Nepal","volume":"103","author":"Pandey","year":"2008"},{"key":"b22","series-title":"Mem Inst Oswaldo Cruz","first-page":"207","article-title":"Leishmania infection in humans, dogs and sandflies in a visceral leishmaniasis endemic area in Maranh\u00e3o, Brazil","volume":"106","author":"Felipe","year":"2011"},{"key":"b23","series-title":"Acta Trop","first-page":"106789","article-title":"Ecology and natural infection of phlebotomine sand flies in different ecotopes and environments in the municipality of Pains, Minas Gerais, Brazil","volume":"238","author":"Capucci","year":"2023"},{"key":"b24","series-title":"Vector Borne Zoonotic Dis","first-page":"467","article-title":"Prevalence of sand flies and Leishmania donovani infection in a natural population of female Phlebotomus argentipes in Bihar State, India","volume":"12","author":"Tiwary","year":"2012"},{"key":"b25","series-title":"Ann N Y Acad Sci","first-page":"157","article-title":"Impact of recent and future climate change on vector\u2010borne diseases","volume":"1436","author":"Caminade","year":"2019"},{"key":"b26","series-title":"Acta Trop","first-page":"144","article-title":"Species composition and activity patterns of sand flies (Psycodidae: Phlebotomine) in four tehsils of Dir Districts, Khyber Pakhtunkhwa, Pakistan","volume":"156","author":"Ali Khan","year":"2016"},{"key":"b27","series-title":"Trop Med Int Health","first-page":"192","article-title":"Barriers of visceral leishmaniasis reporting and surveillance in Nepal: comparison of governmental VL-program districts with non-program districts","volume":"24","author":"Lim","year":"2019"}],"container-title":["The American Journal of Tropical Medicine and 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