Kala Azar – India missed 2017 elimination deadline
How can India manage the menace of Kala Azar
Finance minister Arun Jaitley in his 2017-18 budget speech had set the deadline of 2017 to eliminate Kala Azar (black fever) disease from India. In seventeen districts of Bihar and Jharkhand, the prevalence of Kala-Azar endemic blocks have actually increased from 61 to 68.
The deadline for elimination of Kala-Azar has been consistently postponed from 2010 to 2015 and then to 2017. Elimination criteria for Kala Azar disease is to reduce it to below 1 case for 10,000 persons at sub-district levels.
Reasons for missing deadline to eliminate Kala Azar
- There is an increase in the number of active cases findings rather than actual increase in kala-azar endemic blocks.
- For elimination of Kala Azar, there is a need to eliminate Kala Azar vector. Majority of the endemic blocks have wooden houses. For the elimination of Kala-Azar vector, there is a need to build concrete houses in Kala-Azar affected areas.
- The constructions of the concrete houses are pending since 2001-02. This is the primary reason behind missing the deadline of 2017 for the elimination of Kala-Azar disease from India.
- Earlier DDT was used for controlling vector-borne diseases however it was later on discontinued owing to its side effects on human health and environment.
- Further the Post Kala Azar Dermal Leishmaniasis (PKDL) a lesser known skin condition is also rising over the past few years.
- In some cases, the parasite has developed resistance from the only drug (SSb injection) which has worsened the crisis.
Measures to control Kala Azar disease
- Since 2003 the government had launched National Vector Borne Disease Control Programme (NVBDCP) to eliminate the Kala Azar disease.
- With funds from NVBDCP and World Bank-supported projects (2008-2013), the Kala Azar Technical Supervisor (KTS) has been appointed at State's blocks to conduct active surveillance. Accredited social health activists (ASHAs) are entrusted to visit houses and look for patients with symptoms of Kala-Azar.
- Now New Rapid Diagnostic Test called rK39 are used to detect the Kala Azar disease.
- To expedite and complete the building of concrete houses request has been sent to Ministry of Rural Development.
- The government has given directions to spray insecticide synthetic pyrethroid as a substitute for DDT. There is a need to improve the sanitary conditions to stop the breeding of vectors like sand-fly mosquitoes etc.
Basic facts about Kala Azar
- Kala Azar which is also known as the Black fever is a vector-borne disease caused by the protozoan parasite of genus Leishmania. It is the only Kala Azar parasite causing Kala Azar disease in India. It is transmitted by Kala Azar vector, a sand-fly of genus Phlebotomus argentipes a blood-sucking pest found in moist and humid areas.
- Post Kala Azar dermal leishmaniasis PKDL is a skin condition which can develop after few years of treatment of Kala-Azar disease.
- The Kala Azar symptoms are recurrent fever, loss of appetite, weight loss, liver enlargement and swelling, anemia and dry skin among the Kala Azar patients.
- The disease belongs to the family of neglected tropical disease (NTD) which affects the poorest of the poor population of the world.
- The Kala Azar disease is endemic to India, Bhutan, Bangladesh, and Nepal affecting around 119 districts.
- The parasite has emerged as an opportunistic infection which is affecting HIV and other immunosuppressed patients.