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close this bookWHO Recommended Surveillance Standards (WHO; 1999; 157 pages)
View the documentAcknowledgements
View the documentAcronyms
View the documentIntroduction
View the documentNational Coordination of Communicable Disease Surveillance
View the documentExplanatory notes
View the documentSurveillance activities: criteria and WHO Department
View the documentCommunicable disease contacts in Regional Offices
close this folderDiseases
View the documentB20-B21-B22-B23-B24 AIDS
View the documentA22 Anthrax
View the documentA23 Brucellosis
View the documentA00 Cholera
View the documentA81.0 Creutzfeldt-Jakob disease
View the documentA90, A91 Dengue fever (A90) including Dengue haemorrhagic fever (DHF) & Dengue shock syndrome (DSS, A91)
View the documentA36 Diphtheria
View the documentB72 Dracunculiasis (Guinea worm disease)
View the documentA98.3, A98.4 Ebola-Marburg viral diseases
View the documentA83.0 Japanese encephalitis
View the documentB74 Lymphatic filariasis
View the documentB96.3 Haemophilus influenzae type b
View the documentB15-B17 Acute viral hepatitis
View the documentB20-B24 HIV infection
View the documentJ10, J11 Influenza
View the documentA96.2 Lassa fever
View the documentA48.1 Legionellosis
View the documentB55.1, B55.2 Cutaneous leishmaniasis
View the documentLeishmania / HIV co-infections
View the documentB55.0 Visceral leishmaniasis
View the documentA30 Leprosy
View the documentA27 Leptospirosis
View the documentB50-54 Malaria
View the documentB05 Measles
View the documentA39 Meningococcal disease
View the documentA87 Viral meningitis
View the documentB73 Onchocerciasis
View the documentA37.0 Pertussis
View the documentA20 Plague
View the documentA36 Poliomyelitis
View the documentA82 Rabies
View the documentA02.0 Salmonellosis
View the documentB65 Schistosomiasis
View the documentA50-52 Syphilis
View the documentA33 Tetanus, neonatal
View the documentB56-0, B56-1 African trypanosomiasis
View the documentB57 American trypanosomiasis
View the documentA15-A19 Tuberculosis
View the documentA75.3 Scrub typhus
View the documentA95.9 Yellow fever
open this folder and view contentsSyndromes
View the documentAnnex 1 Software free and in the public domain
View the documentAnnex 2 Proposed surveillance definitions
View the documentAnnex 3 Role and use of Geographic Information Systems (GIS) and mapping for epidemiological surveillance
 

B55.0 Visceral leishmaniasis

RATIONALE FOR SURVEILLANCE:

Visceral leishmaniasis is endemic in over 60 countries. The incidence is estimated at 500 000 cases each year. It is the most severe form of leishmaniasis and it can be fatal in the absence of treatment. Deadly epidemics frequently occur in the anthroponotic foci of Bangladesh, India, Nepal and Sudan, where humans are believed to be the sole reservoir. Surveillance is essential in establishing disease impact and monitoring efforts towards disease control and detecting epidemics.

RECOMMENDED CASE DEFINITION

Clinical description

An illness with prolonged irregular fever, splenomegaly and weight loss as its main symptoms.

Laboratory criteria for diagnosis

 

• positive parasitology (stained smears from bone marrow, spleen, liver, lymph node, blood or culture of the organism from a biopsy or aspirated material)

• positive serology (IFA, ELISA)

Case classification

WHO operational definition:

A case of visceral leishmaniasis is a person showing clinical signs (mainly prolonged irregular fever, splenomegaly and weight loss) with serological (at geographical area level) and/or parasitological confirmation (when feasible at central level) of the diagnosis. In endemic malarious areas, visceral leishmaniasis should be suspected when fever lasts for more than two weeks and no response has been achieved with anti-malaria drugs (assuming drugresistant malaria has also been considered).

RECOMMENDED TYPES OF SURVEILLANCE

Routine monthly reporting of aggregated data from periphery to intermediate and central level.

Active case finding through surveys of selected groups or mass surveys (standardized and periodical) is an alternative to estimate the prevalence of visceral leishmaniasis.

International: Annual reporting from central level to WHO (limited number of countries).

RECOMMENDED MINIMUM DATA ELEMENTS

Individual patient records at peripheral level

 

Identification data: Unique identifier, age, sex, geographical information, travel history, duration of stay at current residence.

Leishmaniasis data: Clinical features, date of diagnosis, serological/parasitological diagnosis, Leishmania species, treatment outcome.

Aggregated data for reporting

Number of cases by age, sex, type of diagnosis.

RECOMMENDED DATA ANALYSIS, PRESENTATION, REPORTS

Tables: Incidence by geographical area, age, sex, type of diagnosis, risk group, by clinical features, by month/year. Point prevalence (if active case detection).

PRINCIPAL USES OF DATA FOR DECISION-MAKING

 

• Evaluate the real extent of the problem and the main populations at risk
• Improve and focus the control activities
• Identify technical and operational difficulties
• Evaluate impact of control interventions
• Anticipate epidemics

SPECIAL ASPECTS

Visceral leishmaniasis tends to be largely underreported because most of the official data are obtained through passive case detection only. The number of people exposed to infection or infected without any symptoms is much more important than the number of detected cases.

CONTACT

Regional Offices:

See Regional Communicable Disease contacts on section "Communicable disease contacts in Regional Offices".

Headquarters: 20 Avenue Appia, CH-1211 Geneva 27, Switzerland

Department of Communicable Disease Surveillance and Response (CSR)

 

E-mail: desjeuxp@who.ch / Surveillancekit@who.ch
Tel: (41 22) 791 38 70
Fax: (41 22) 791 4898 attn CSR
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