title: Exposure to Phlebotomus argentipes (Diptera, Psychodidae, Phlebotominae) sand flies in rural areas of Bihar, India: the role of housing conditions.
abstract: BACKGROUND
  Visceral Leishmaniasis (VL) is a vector-borne infectious disease, caused by the protozoan Leishmania donovani, which is transmitted by phlebotomine sand flies. In an earlier study in Bihar, India, we found an association between incidence of VL and housing conditions. In the current study we investigated the influence of housing structure and conditions in and around the house on the indoor abundance of Phlebotomus argentipes, the vector of VL in this area.
  
  
  METHODS
  In each of 50 study villages in Muzaffarpur district, we randomly selected 10 houses. Light traps were installed in each house for one night during three annual peaks of sand fly density over two successive years. Sand flies captured were morphologically identified and segregated by species, sex and feeding status. Data on housing conditions and socio-economic status were also collected. We fitted a linear mixed-effects regression model with log-transformed P. argentipes counts as outcome variable and village as random effect.
  
  
  RESULTS
  P. argentipes was found in all but four of the 500 households. There was considerable variability between the years and the seasons. On bivariate analysis, housing structure, dampness of the floor, keeping animals inside, presence of animal dung around the house, and socio-economic status were all significantly associated with sand fly density. Highest sand fly densities were observed in thatched houses. In the multivariate model only the housing structure and socio-economic status remained significant.
  
  
  CONCLUSIONS
  Better housing conditions are associated with lower sand fly densities, independent of other socio-economic conditions. However, in this area in Bihar even in the better-built houses sand flies are present.
authors.affiliation: Institute of Medical Sciences Banaras Hindu University, Varanasi, India; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; International Health Unit, University of Antwerp, Antwerp, Belgium.
authors.forename: Paritosh
authors.initials: P
authors.lastname: Malaviya
authors.affiliation: Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
authors.forename: Epco
authors.initials: E
authors.lastname: Hasker
authors.affiliation: Centre de Recerca en Salut Internacional de Barcelona (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Picado
authors.affiliation: Institute of Medical Sciences Banaras Hindu University, Varanasi, India.
authors.forename: Mukesh
authors.initials: M
authors.lastname: Mishra
authors.affiliation: International Health Unit, University of Antwerp, Antwerp, Belgium.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Van Geertruyden
authors.affiliation: B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
authors.forename: Murari Lal
authors.initials: ML
authors.lastname: Das
authors.affiliation: Institute of Medical Sciences Banaras Hindu University, Varanasi, India.
authors.forename: Marleen
authors.initials: M
authors.lastname: Boelaert
authors.affiliation: Institute of Medical Sciences Banaras Hindu University, Varanasi, India.
authors.forename: Shyam
authors.initials: S
authors.lastname: Sundar
mesh_terms: D000818:Animals; D005260:Female; D007194:India / Q000453:epidemiology; D007303:Insect Vectors / Q000502:physiology*; D007893:Leishmania donovani; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000635:transmission; D008297:Male; D008954:Models, Biological; D010691:Phlebotomus / Q000502:physiology*; D012621:Seasons; D012939:Social Planning