India Nears Kala Azar Elimination

• 12 Dec 2023

Source: IE

Why in News?

India stands on the brink of eliminating visceral leishmaniasis, commonly known as kala azar. With a marked decline in reported cases and deaths, the nation has come close to meeting the elimination target set by the World Health Organization (WHO).

• Bangladesh, India's neighbour, was the first country validated by the WHO for eliminating kala azar as a public health problem.

What is Kala-Azar?

• About:
  • Visceral leishmaniasis commonly known as kala-azar, is a slow-progressing indigenous disease caused by a protozoan parasite of genus Leishmania.
    • It is also known as Black Fever or Dumdum Fever.
    • In India Leishmania donovani is the only parasite causing this disease.
• Transmission and Symptoms:
  • It is transmitted by sandflies. Sandflies of the genus Phlebotomus argentipes are the only known vectors of kala-azar in India.
  • It causes fever, weight loss, and spleen and liver enlargement. If left untreated, it can be fatal in 95% of cases.
• Recorded Cases in India:
  • India documented 530 cases and four deaths in 2023, a decline from previous years.
    • Additionally, there were 286 cases of post-kala azar dermal leishmaniasis (PKDL).
• Post Kala-azar Dermal Leishmaniasis (PKDL):
  • This condition arises when Leishmania donovani infiltrates and thrives within skin cells, resulting in the formation of skin lesions.
  • In some instances of kala-azar, PKDL emerges after treatment, but now it is believed that PKDL might occur without going through the visceral stage. However, more data is needed to understand how PKDL develops.
    • The visceral stage refers to the initial phase of visceral leishmaniasis (kala-azar), where the parasite affects internal organs.
• Treatment:
  • In India, the primary treatment for kala-azar involves administering injectable liposomal amphotericin B.
    • For PKDL, the standard treatment consists of 12 weeks of oral miltefosine, with the dosage adjusted based on the patient's age and weight.
• Strategies for Elimination in India:
  • Effective Spraying: Rigorous monitoring of indoor residual spraying to curb sandfly breeding and disease spread.
  • Wall Plastering: Using Gerrard soil for wall plastering to minimize sandfly breeding areas.
  • Treatment Compliance: Ensuring completion of PKDL treatment through the ASHA (Accredited Social Health Activist) network.

Note

WHO has set a target of 2030 to eliminate Kala-azar. The WHO's Neglected Tropical Diseases Road map also includes this target.

• Government of India launched a centrally sponsored Kala-azar control Programme in 1990-91. The National Health Policy (2002) envisaged kala-azar Elimination by 2010 which was revised later to 2015. Now Kala-azar is targeted for elimination by 2023 in India.