INDIA ACHIEVES TARGET TO ELIMINATE ‘KALA-AZAR’

India has achieved its target to eliminate visceral leishmaniasis, commonly known as kala-azar, according to data from the National Centre for Vector Borne Diseases Control (NCVBDC). India had initially aimed to eliminate kala-azar by 2010, but the target was extended until 2023 due to persistent challenges.

The National Vector Borne Disease Control Programme (NVBDCP) started in 2003-04 to prevent and control diseases like Japanese Encephalitis (JE), Dengue, Kala-azar, Lymphatic Filariasis, Malaria, and Chikungunya.

Decline in Kala Azar Cases in India

1. In 2023, India fulfilled the World Health Organization's (WHO) elimination criteria for kala-azar by recording only 520 cases nationwide.
2. WHO's criteria requires that no area within a country should report more than one case per 10,000 people.
3. In 2020, India accounted for 18% of the world's kala-azar cases, as per WHO data.

What is Kala-Azar?

Aspect	Details
About	Kala-azar, also known as visceral leishmaniasis, is a parasitic disease caused by Leishmania parasites (Leishmania donovani in India). It is a neglected tropical disease and is the second-largest parasitic killer in the world (after malaria).
Transmission	It is transmitted through the bite of infected sandflies.
Symptoms	Fever, weight loss, enlargement of the spleen and liver, and anemia
Impact	Kala-azar primarily affects the spleen, liver, and bone marrow.
Fatality rate	95%, if left untreated.
Treatment	Injectable liposomal amphotericin B is administered. A 12-week course of Oral Miltefosine is prescribed for PKDL (Post Kala-Azar Dermal Leishmaniasis).

Note- Post kala-azar cutaneous leishmaniasis (PKDL) – This occurs when Leishmania donovani invades and multiplies skin cells, causing skin lesions. PKDL usually appears after kala-azar treatment.

Strategies Adopted to Eliminate Kala Azar in India

1. Intensive indoor residual spraying: To target and reduce sandfly breeding areas, intensive indoor residual spraying is performed.
2. Plastering the wall with Gerard clay: To prevent sand flies from making nests, the walls are coated with a specific clay known as Gerard clay.
3. Treatment Compliance Monitoring: The Accredited Social Health Activists (ASHA) network is engaged in monitoring the completion of treatment of PKDL patients while ensuring compliance.

Three mains form of the Kala-azar

1. Visceral leishmaniasis (VL), the most severe form of leishmaniasis, affects multiple organs.
2. Cutaneous leishmaniasis (CL), the most common form, causes skin ulcers, primarily on exposed body parts, which can lead to permanent scars, disability, or stigma.
3. Mucocutaneous leishmaniasis, a severe form, destroys mucous membranes in the nose, mouth, and throat, leading to extensive damage.

The Indian government has taken several steps to eliminate kala-azar, also known as visceral leishmaniasis, including:

Programmatic activities:

The National Vector Borne Disease Control Programme (NVBDCP), which is part of the National Health Mission (NHM), is responsible for implementing these activities.

Housing:

The PM-AWAS yojana has built concrete houses in areas where kala-azar is prevalent.

Testing:

The government supports testing for kala-azar.

Treatment:

The government has introduced a new, single-dose treatment with liposomal amphotericin B. It also supports the states in providing medicines, diagnostic kits, and sprays.

Surveillance:

The government has introduced case-based surveillance and electronic health records to facilitate monitoring and prompt action.

Support:

The government has provided support to states for active case detection, surveillance, treatment, and supply of diagnostic kits, medicines, and sprays.

Other measures include:

1. Microstratification in high-risk areas
2. Regular review of programs by technical advisory groups
3. Collaboration with a network of partners
4. Integrated vector management
5. Capacity building
6. Monitoring and evaluation
7. Operational research

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