Kala-Azar

What is Kala-Azar?

• Kala-azar or Visceral Leishmaniasis is a protozoan parasitic disease, spread by sandfly bites. 
• Sandflies are brown in colour and have hairs on their bodies. The flies are infected with the parasite called ‘leishmania donovani’.
• The vector sandfly is known to live in cracks and crevices of muddy houses, especially in dark and humid corners. 
• According to the WHO,there are 3 main forms of leishmaniasis – 
  1. Visceral (also known as kala-azar, which is the most serious form of the disease).
  2. Cutaneous (the most common), and causes skin lesions, mainly ulcers, on exposed parts of the body.
  3. Mucocutaneous- It leads to partial or total destruction of mucous membranes of the nose, mouth and throat.
• The disease affects some of the poorest people and is linked to malnutrition, population displacement, poor housing, a weak immune system and a lack of financial resources. 
• Leishmaniasis is also linked to environmental changes such as deforestation, and urbanisation, according to WHO.
• The disease is known to be fatal in over 95 per cent of the cases, if left untreated.
• Irregular bouts of fever over many days, weight loss, enlargement of the spleen and liver, and anaemia are known symptoms. 
• The skin may become dry, thin and scaly in patches and hair may be lost. In people with a light skin tone, greyish discolouration of the skin of hands, feet, abdomen and face may be seen, that is why the disease is also called “Black fever”.
• It is a treatable and curable disease, which requires an immunocompetent system and thus those having a weak immune system are prone to get severely affected.  
• Anti-leishmanial medicines are available for treatment. Vector control is also recommended by the WHO, which means reducing or interrupting the transmission of disease by decreasing the number of sandflies in surroundings through insecticide spray, use of insecticide-treated nets, etc.
• In 2020, more than 90 per cent of new cases reported to WHO occurred in 10 countries: Brazil, China, Ethiopia, Eritrea, India, Kenya, Somalia, South Sudan, Sudan and Yemen.

Kala-Azar disease in India-

• The disease is endemic in Bihar, Jharkhand, Uttar Pradesh and West Bengal. An estimated 165.4 million people are at risk, according to data from the National Centre for Vector Borne Disease Control Programme (NCVBDC). 
• In the country as a whole, there has been a significant decline in cases over the years. In 2014, around 9,200 cases were reported while in 2021 the number fell to 1,276 cases.
• In West Bengal, the districts where the maximum number of cases were registered include Darjeeling, Malda, Uttar Dinajpur, Dakshin Dinajpur and Kalimpong. 
• The government aimed to eliminate the disease in India by 2015, but that deadline was missed. However, the number of cases has been brought down significantly through the National Kala-Azar Elimination Programme.
• Medicines, insecticides and technical support were given by the central government, while state governments provided for costs involved in implementation.