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.
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.
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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)
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.
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- 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. |
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- 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
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- 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
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February 23, 2024