Entomological evidence to support Visceral Leishmaniasis elimination in Nepal

Visceral leishmaniasis (VL) or kala-azar, the most severe form of leishmaniasis, is caused in Nepal by Leishmania donovani and transmitted through the bite of the female vector sand fly; Phlebotomus argentipes. As the disease is most prevalent among the economically deprived communities in rural or urban areas, the government of Nepal has been committed to eliminate this disease as a public health problem with a target annual incidence below one per 10,000 people at district level since 2005. The target was achieved and sustained since 2013, albeitwith the exception of one district in 2017. Despite this progress, the National VL elimination programme is still confronted with many challenges on its way, among other the increasingly wide spread distribution of VL cases over the country, and the questionable efficacy of the main vector control activity indoor residual spraying (IRS). A multidisciplinary approach is needed to resolve these emerging challenges. In this research, we will focus on entomological approach by bringing up to date evidence on vector distribution, ecology and behaviour, improved vector surveillance and susceptibility status of the vector for the recommended insecticides used in indoor residual spraying in Nepal.