Kala Azar/ Black Fever/Dumdum Fever (Visceral Leishmaniasis): Causes, Symptoms, and Treatment

GS Paper III Science and Technology

Context:

Recently, India hit a target towards eliminating Kala Azar as reported less than one case per 10,000 population across all blocks in 2023.

Data from the National Vector Borne Disease Control Programme (NVBDCP) showed that there were 595 cases & 4 deaths of Kala Azar reported nationwide compared to 891 cases & three deaths in 2022.

National Vector Borne Diseases Control Programme (NVBDCP)

It is an umbrella programme for the prevention and control of vector-borne diseases namely Malaria, Japanese Encephalitis, Dengue, Chikungunya, Kala-azar and Lymphatic Filariasis.
Out of them three diseases namely, Malaria, Lymphatic Filariasis and Kala-azar are targeted for elimination.

It is a neglected tropical disease affecting almost 100 countries including India.
Caused by: infection with Leishmania parasites. (Leishmania donovani in India)

Neglected Tropical Disease(NTDs):

They are ‘neglected’ because they are almost absent from the global health agenda
NTDs are a diverse group of conditions caused by various pathogens (including viruses, bacteria, parasites, fungi and toxins).
Geographical Distribution: These diseases disproportionately affect low-income populations residing in developing regions across Africa, Asia, and the Americas.
WHO recognizes more than 20 NTDS: Chagas disease; dengue and chikungunya; dracunculiasis; leishmaniasis; leprosy; lymphatic filariasis; chromoblastomycosis and rabies; soil-transmitted helminthiases; snakebite envenoming; trachoma; and yaws etc.
Global Impact: It is prevalent in 149 countries and impacting over 1.5 billion individuals, including more than 450 million children.
WHO Roadmap goal for NTDs 2021-2030.

Types of leishmaniasis:
- Visceral leishmaniasis affects multiple organs and is the most serious disease.
- Cutaneous leishmaniasis causes skin sores and is the most common form.
- Mucocutaneous Leishmaniasis, which causes skin and mucosal lesions.
Spread through sandfly bites.
Kala Azar Symptoms: Fever, weight loss and swelling of the spleen or liver.
Fatality : 95%, if left untreated.
Kala Azar Treatment:
- Administration of injectable liposomal amphotericin B.
- For PKDL (Post Kala-Azar Dermal Leishmaniasis) : Oral Miltefosine.
Strategies Adopted to Eliminate Kala Azar in India: 3 key interventions

Post Kala-azar Dermal Leishmaniasis (PKDL): It develops when Leishmania donovani infiltrates and proliferates within skin cells, leading to the formation of skin lesions. While PKDL generally arises subsequent to kala-azar treatment.

- Spraying: Rigorous indoor residual spraying effort aimed at curbing sandfly breeding sites.
- Wall Plastering: Application of a special soil (Gerrard Soil) on walls, preventing sand flies from nesting.
- Treatment Compliance: Mobilization of ASHA (Accredited Social Health Activist) network to ensure completion of treatment PKDL patients.

World Health Organisation (WHO) Targets: Under Neglected Tropical Diseases Roadmap,target for Eliminating Kala-azar by 2030.
Government Initiatives:
- The Government of India initiated Kala-azar control programme in the endemic states in 1990-91.
- National Health Policy and Revised Targets: The National Health Policy of 2002 initially aimed for Kala-azar elimination by 2010, later revising it to 2015, 2017, and 2020.
- Collaborative Partnerships and Oversight: Between Bill & Melinda Gates Foundation (BMGF), the National Centre for Disease Control (NCDC), and the World Health Organization (WHO) to achieve Kala-azar elimination.
Major Development:
- In October 2023, Bangladesh became the first country in the world officially validated by WHO for eliminating Kala Azar as a Public health concern.
In India
- Elimination status: Less than one case per 10,000 Progress:
- More than 98 % decline in cases of Kala-azar (2007 to 2022) in India.
- Kala Azar Endemic states: 633 blocks mainly in four Bihar, Jharkhand, West Bengal & Uttar Pradesh.
- Uttar Pradesh & West Bengal states have achieved their targets.

Also Read: World’s First Vaccine For Chikungunya Approved

News Source: IE

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