- Case management
- Improving surveillance
- Validate and upscale index case detection and camp approaches for Active Case Detection of post-kala azar dermal leishmaniasis and VL.
- Increase awareness of established incentives for Community Health Workers (Accredited Social Health Activist) and patients.
- Training of Indoor Residual Spraying technicians to conduct active case detection for post-kala azar dermal leishmaniasis and VL.
The active-case detection programme has begun its phase 1 roll-out in Bihar. Preparations (village mapping, approvals from government, liaising with district and block officials and training of front line workers) have been completed and field work has begun. In 3 days of "real" field operations 10 field teams (one person from IPE Global: India and one government staff member) covered 2760 households, equivalent to approximately 14,000 people. Most of the households were situated in very poor communities. We found 122 suspect cases of VL and PKDL.
We also introduced active-case searching through the Behaviour change communication (BCC) teams of New Concepts. Under this component the team from NC, after the Information Education Communication/BCC session (community group session), searched for any suspected VL or PKDL cases. This was done mainly through asking questions to the communities they interacted with, or by asking community health workers or other key people in the community. The teams have been able to identify more than 1,800 suspected cases of VL or PKDL, of which 211 were confirmed as VL and 35 as PKDL. These confirmed cases were then referred to PHC (via a referral slip). However, only 50% of these individuals went to the PHC for confirmatory diagnosis. We are looking at ways to increase this proportion.