In Bangladesh the elimination target is set at less than one new case per 10,000 population per year at upazila (sub-district) level by 2015. Between 1994 and 2013, 109,266 kala-azar cases causing 329 deaths were reported from 37 endemic districts in Bangladesh. Only 16 districts reported cases every year. The Mymensingh district was the most affected with 53,582 (49.04%) cases. Between 2008 and 2013 only 16 upazilas showed incidence rates above the elimination target in which they ranged from 1.06 to 18.25 per 10,000 people per year. While clear progress has been made towards eliminating VL, 16 upazilas in Bangladesh had not yet reached the target in 2013, based on official notification data that probably suffered from under-reporting bias. The elimination initiative urgently needs to establish methods to ascertain and monitor the elimination target.
Chowdhury, R.; Mondal, D.; Chowdhury, V.; Faria, S.; Alvar, J.; Nabi, S.G.; Boelaert, M.; Dash, A.P. How Far Are We from Visceral Leishmaniasis Elimination in Bangladesh? An Assessment of Epidemiological Surveillance Data. PLoS Neglected Tropical Diseases (2014) 8 (8) e3020. e3020. [DOI: 10.1371/journal.pntd.0003020]