Epidemiologic Correlates of Mortality among Symptomatic Visceral Leishmaniasis Cases: Findings from

More than 70% cases of visceral leishmaniasis (VL), a parasitic disease transmitted by sand flies, in India are reported from Bihar, a resource-poor state. In absence of early diagnosis and treatment, the fatality is very high among symptomatic VL cases. However, community-based data on VL mortality is limited in Bihar. Also, little information on the factors associated with mortality among symptomatic VL patients is available from this Indian state. Evidences regarding mortality parameters can prove immensely helpful in designing specific interventions targeted at reduction of such mortality. In the current study, we created a registry of symptomatic VL cases in eight districts of Bihar to estimate the burden of VL mortality and the socio-demographic factors associated with it. The mortality rate among the symptomatic VL patients was found to be fairly high. Shorter interval between onset of symptoms and diagnosis, and completing course of treatment were associated with increased survival. We recommend improving access to early diagnosis and treatment services, especially among the marginalized communities, as a key measure to reduce mortality among symptomatic VL patients in Bihar.