Figure 1.

Flow chart of VL reporting systems in Nepal and India. The standard hierarchical way of VL reporting from district level to state/ national level is depicted with red arrows. Alternative reporting strands are depicted with black arrows. The time of VL case reporting from district to center, T_R, was recorded for the standard as well as for alternative reporting strands. In Nepal, VL case information from HMIS is used by ECDC. In Bihar/India, HMIS does not provide VL case information to SMO. In Nepal, EWARS sites conduct VL sentinel reporting whereas in India no VL sentinel sites were active. Abbreviations used in this figure can be found in the text or the list of abbreviations.