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HindustanTimes Wed,17 Sep 2014

India targets kala-azar elimination by 2015

Sanchita Sharma, Hindustan Times  New Delhi, August 28, 2014
First Published: 20:41 IST(28/8/2014) | Last Updated: 20:44 IST(28/8/2014)

Using a single-dose drug for treatment and independent experts to monitor implementation are part of the Centre’s new roadmap to eliminate kala-azar (visceral leishmaniasis or black fever) by 2015.
 
India has till now eradicated small-pox, rinderpest (cattle plague) and polio.
 
The parasite, which spreads between humans through the bite of an infected sandfly, attacks the immune system and can kill, if not treated.
 
Kala-azar is the second-largest parasitic killer after malaria worldwide, causing an estimated 2 lakh new infections each year. Since humans are the only hosts of the parasite, early detection and treatment makes elimination achievable.
 
India accounts for half of the new infections, with the disease flourishing in 54 districts – 33 in Bihar, 4 in Jharkhand, 11 in West Bengal and 6 in eastern Uttar Pradesh.
 
“India has set its elimination target to lower infection to one per 10,000 at the block level in the 54 affected districts,” said Union Health Minister Harsh Vardhan.
 
Much of the diagnosis, management and monitoring will be done through “active surveillance” using health workers and volunteers trained for polio eradication.
 
The new guidelines recommend everyone with fever for more than two weeks and an enlarged liver and/or spleen to be tested using a dipstick test. For people with a past history or high suspicion for kala-azar but who test negative using the dipstick test, lab confirmation of spleen and bone marrow samples at a district hospital will be done.
 
Only people with confirmed diagnosis are treated since everyone infected does not develop the disease.

“India has already met with some success, with new infection dropping by 58% and deaths by 75% between 2011 and 2013. Early diagnosis and using a single-dose drug called liposomal amphotericin (LAMB) given intravenously has helped reduce the human reservoir of infection,” Vardhan said.


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