Kala-azar Disease | 10 Jan 2023

Why in News?

Kala-azar cases in India declined by 98.7% between 2007 and 2022, from 44,533 to 834 and 632 endemic blocks (99.8%) spread across Bihar, Uttar Pradesh, Jharkhand, and West Bengal have received elimination status (less than one case per 10,000).

• The only block that is still in the endemic category is Littipara in the Pakur district of Jharkhand (1.23 cases per 10,000 population).

What is Kala-azar Disease?

• About:
  • It is also known as Visceral Leishmaniasis or Black Fever or Dumdum Fever.
    • There are three types of Leishmaniasis:
      • Visceral Leishmaniasis, which affects multiple organs and is the most serious form of the disease.
      • Cutaneous Leishmaniasis, which causes skin sores and is the most common form.
      • Mucocutaneous Leishmaniasis, which causes skin and mucosal lesions.
  • It is a deadly parasitic disease caused by the protozoa parasite Leishmania and mainly affects the people living in Africa, Asia and Latin America.
  • The disease can cause death, if left untreated.
• Global and National Status:
  • According to the World Health Organization (WHO), Kala-azar is the second deadliest parasitic disease in the world, and as of November, 2022, about 89% of global cases are reported from eight countries: Brazil, Eritrea, Ethiopia, India, Kenya, Somalia, South Sudan, and Sudan.
  • India contributes about 11.5% of total cases of Kala-azar reported globally.
    • Over 90% of kala-azar cases in India are reported from Bihar and Jharkhand, while Uttar Pradesh and West Bengal have achieved their elimination targets at the block level.
• Transmission:
  • It is transmitted to humans by the bite of an infected female phlebotomine sandfly.
• Signs and Symptoms:
  • Fever, weight loss, anemia, and enlargement of the liver and spleen.
• Prevention:
  • Prevention of kala-azar involves measures to reduce the breeding sites of sandflies and to protect people from sandfly bites.
    • This can be achieved through the use of insecticides, bed nets, and repellents, as well as the improvement of housing conditions and access to clean water and sanitation.
    • The WHO also recommends Mass Drug Administration (MDA) in areas where the disease is endemic.
• Treatment:
  • The treatment of kala-azar involves the use of drugs, such as sodium stibogluconate and meglumine antimoniate.
    • The WHO recommends a combination of two or more drugs for the treatment of kala-azar, as monotherapy has a higher risk of treatment failure and drug resistance.
• Related Initiatives:
  • Global:
    • WHO’s New Roadmap for 2021–2030: To prevent, control, eliminate and eradicate a set of 20 diseases, termed neglected tropical diseases, by 2030.
    • The WHO has also established the Global Programme to Eliminate Lymphatic Filariasis (GPELF), which aims to eliminate lymphatic filariasis, onchocerciasis, and Kala-azar by MDA.
      • The target set by GPELF in 2000 to eliminate these diseases globally by 2020 was not achieved. Despite setbacks due to Covid-19, WHO will accelerate work to achieve this target by 2030.
  • Indian:
    • The central government has taken several steps to achieve its goal of eliminating kala-azar from India by 2023, including building pucca houses through the PM-AWAS yojana, rural electrification, testing, treatment, periodic high-level review, and award distribution.
      • The Centre is also supporting the states in active case detection, surveillance, treatment, and supply of diagnostic kits, medicines, and sprays.
    • National Kala-azar Elimination Programme
      • The National Health Policy-2002 set the goal of Kala-azar elimination in India by the year 2010 which was revised to 2015.
      • India signed a Tripartite Memorandum of Understanding (MoU) with Bangladesh and Nepal to achieve Kala-azar elimination from the South-East Asia Region (SEAR).
      • Presently, all programmatic activities are being implemented through the National Vector Borne Disease Control Programme (NVBDCP) which is an umbrella programme and is subsumed under National Health Mission (NHM).

Source: DTE