Visceral Leishmaniasis also called Kala Azar in the Indian Subcontinent is yet to be eradicated, Visceral leishmaniasis is caused by deadly protozoan parasite genus Leishmania. This deadly disease is characterized by anemia, weight loss, splenomegaly, irregular bouts of fever, hepatomegaly. This deadly disease is epidemic in more than 80 countries however the majority of the cases are reported from six countries that include: India, Brazil, Ethiopia, South Sudan, Somalia and, Sudan. All over the World, the estimated number of cases is around 2,00,000- 4,00,000 and around 40,000 deaths occur all over the globe. In India, Visceral Leishmaniasis is a pure anthroponotic and parasite that are spread to humans by the bite of an infected female sand fly species Phlebotomus argentipes. India alone accounts for 2/3rd of the global gases of which the state of Bihar alone has 50% of the cases and 61.1% of the Cases in India are from Bihar. Kala Azar is a public health problem in Bihar and in 2015 Government of India entrusted ICMR-Rajendra Memorial Research Institute of Medical Sciences, Patna, to implement an integrated control strategy for achieving the Visceral Leishmaniasis elimination target.
India and Kala-Azar
The Indian Government initiated the Visceral Leishmaniasis program in 1990-1991. In 2005 under WHO and including other countries of Nepal and Bangladesh developed a strategic framework in eliminating Visceral Leishmaniasis as a Public Health problem by 2015, but was later postponed to 2017 and again in 2020 and it is expected that this will be postponed again and in 2002 the Government launched the National Health Policy to eliminate Visceral Leishmaniasis in the region by 2010. India’s Kala-azar surveillance system is shaky and is not proper in detecting the hotspot areas and in providing the health workers with accurate information about the disease. There are some areas where the reach of health workers is negligible and the government needs to take the required steps to eradicate this problem.
The Government needs to :
A. Detect the disease early and provide early treatment for Kala-azar.
B. The government should have effective Survillenance of the diseases.
In India, the spraying of or Indoor residual spraying (IRS) with dichlorodiphenyltrichloroethane (DDT) was mandated and is being used regularly since 1976. Mostly Kala-azar is confined mostly confined to this states Bihar, Jharkhand, Uttar Pradesh, and West Bengal.
Therefore, are possible chances of controlling the Kala-azar and even have a chance to eliminate it from our country. The scientific feasibility of the elimination strategy is formulated based on the epidemiological vulnerability and how the effectiveness and feasibility of intervention are done and how the numbers are being reduced. However, after several efforts taken from different government and non-governmental organizations, Visceral leishmaniasis is still endemic in the 458 poorest blocks of Bihar. A few Visceral leishmaniasis infected blocks have persistently remained highly endemic for several years and there are no signs of improvement in certain areas regardless of the work done. The Visceral leishmaniasis -vector control program in Bihar has suffered from several problems such as the improper implementation of control strategies, weak monitoring and supervision systems, lack of technological involvement, lack of awareness activities about the program, delay in the diagnosis and treatment of infected patients, and the injudicious application of IRS. Therefore, the implementation of all control strategies in an effective way is a very big and huge task to achieve the Visceral leishmaniasis elimination target in Bihar and India overall.
ACCORDING TO WHO:
Visceral leishmaniasis is the main form of the disease in this Region, also endemic for cutaneous leishmaniasis. The region is the only one with an initiative to eliminate visceral leishmaniasis as a public health problem by 2020. In 2018, the Region observed fewer than 5,000 cases – its the lowest number on record.. The Region is poised to achieve this target, with countries aiming to have WHO validate elimination by 2023.