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

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. 

Decline in Kala Azar Cases in India

• 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.

About Kala Azar

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

• 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

• • 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.

Government Efforts To Eliminate Kala Azar

• 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.

News Source: IE

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