Longlasting insecticidal nets for prevention of Leishmania donovani infection in India and Nepal: paired cluster randomised trial.

Objective: To test the effectiveness of large scale distribution of longlasting nets treated with insecticide in reducing the incidence of visceral leishmaniasis in India and Nepal.

Design: Paired cluster randomised controlled trial designed to detect a 50% reduction in incidence of Leishmania donovani infection.

Setting: Villages in Muzaffarpur district in India and Saptari, Sunsari, and Morang districts in Nepal.

Spatial analysis of Leishmania donovani exposure in humans and domestic animals in a recent kala azar focus in Nepal.

Visceral leishmaniasis (VL) is a major public health problem in the Indian subcontinent where the Leishmania donovani transmission cycle is described as anthroponotic. However, the role of animals (in particular domestic animals) in the persistence and expansion of VL is still a matter of debate. We combined Direct Agglutination Test (DAT) results in humans and domestic animals with Geographic Information System technology (i.