Kala Azar

• 28 Feb 2024

Source: IE

Why in News?

India achieved significant progress in eliminating Kala Azar (KA), reporting less than one case per 10,000 population in 2023, compared to previous years.

• Data from the National Vector Borne Disease Control Programme revealed a decline in Kala Azar cases, with 595 cases and four deaths reported in 2023 compared to 891 cases and three deaths in 2022.

Note:

• India has not yet eliminated KA but has made substantial progress towards its elimination goal.
  • India’s initial target year for Kala Azar elimination was 2010, which was later extended to 2015, 2017, and then 2020.
• The WHO defines elimination for KA as having fewer than one case per 10,000 people at the sub-district (block Primary Health Centres) level in India. Once achieved, the elimination is to be sustained for 3 years for KA elimination certification.
  • India will need to sustain this momentum over the next three years to receive WHO certification, considering that India has missed at least four deadlines for Kala Azar elimination.
• In Oct 2023, Bangladesh became the first country, globally, to be officially validated by the WHO for eliminating Kala Azar as a public health problem.

What are the Key Facts About Kala Azar?

• About:
  • Kala-azar (visceral leishmaniasis), also known as Black Fever is a fatal disease caused by a protozoan parasite Leishmania donovani.
• Symptoms:
  • It is characterised by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia.
• Prevalence:
  • Most cases occur in Brazil, east Africa and India. An estimated 50,000 to 90 000 new cases of VL occur worldwide annually, with only 25-45% reported to WHO. It has an outbreak and mortality potential.
• Transmission:
  • Leishmania parasites spread through bites of infected female sandflies, feeding on blood for egg production. Over 70 animal species, including humans, can carry these parasites.
• Major Risk Factors:
  • Poverty, poor housing, and sanitation.
  • Diets lacking essential nutrients.
  • Movement into high-transmission areas.
  • Urbanisation, deforestation, climate change.
• Diagnosis and Treatment:
  • Suspected visceral leishmaniasis cases require immediate medical attention. Diagnosis involves clinical signs combined with parasitological or serological tests.
    • Left untreated, it can be fatal in 95% of cases.
• Prevention and Control:
  • Early diagnosis and prompt treatment are crucial in reducing disease prevalence, and preventing disabilities, and death.
  • Vector control, such as insecticide spray and the use of insecticide-treated nets, helps reduce transmission by decreasing the number of sandflies.
  • Effective disease surveillance is important for monitoring and acting during epidemics and high case fatality rates.
  • Social mobilization and strengthening partnerships, including community education and collaboration with stakeholders, are critical for effective control.
• India’s Efforts to Control Kala Azar:
  • The Government of India launched a centrally sponsored Kala-azar control program in 1990-91, which was later revised in 2015.
    • The program aimed to eliminate Kala-azar by 2023, aligning with the WHO neglected tropical diseases (NTDs) Roadmap goal of 2030.
  • The National Vector Borne Disease Control Programme (NVBDCP), 2003 is an umbrella programme for prevention and control of vector borne diseases viz., malaria, lymphatic filariasis, kala azar, and chikungunya.
  • Recent Efforts:
    • Rigorous indoor residual spraying effort aimed at curtailing sandfly breeding sites; application of a special soil to seal crevices in mud walls, preventing sandflies from nesting.
    • Pucca houses in KA-affected villages have been constructed under PMAY-G - A total of 25,955 houses in 2017-18 (1371 houses in Bihar & 24584 in Jharkhand).
    • Mobilisation of the ASHA (Accredited Social Health Activist) network to ensure completion of treatment for PKDL patients, who require a 12-week course of Miltefosine (an antileishmanial agent).

Post-kala-azar Dermal Leishmaniasis (PKDL)

• PKDL is a skin condition that follows visceral leishmaniasis, causing rashes on the face, arms, and trunk.
• It affects mainly Sudan and the Indian subcontinent, with 5-10% of kala-azar patients developing it.
• PKDL may occur 6 months to a year after kala-azar treatment, potentially spreading Leishmania.

UPSC Civil Services Examination, Previous Year Questions (PYQs)

Prelims:

Q. Consider the following diseases: (2014)

1. Diphtheria
2. Chickenpox
3. Smallpox

Which of the above diseases has/have been eradicated in India?

(a) 1 and 2 only 
(b) 3 only 
(c) 1, 2 and 3
(d) None

Ans: (b)