How kala-azar was eliminated from a highly endemic district in Bihar - The Hindu -22/11/2020
Kala-azar or visceral leishmaniasis (VL) is a tropical disease characterised by irregular fever, weight loss, anaemia and swelling of the spleen and liver. It is caused by a protozoan Leishmania parasite and is transmitted to humans by the bite of infected female sandflies.
According to the World Health Organisation (WHO) India accounts for about two-thirds of the total 7 to 10 lakh new global cases annually, and the disease is endemic to Bihar, Jharkhand, Uttar Pradesh and West Bengal. An initiative was launched by WHO to eliminate VL as a public health problem from the South East Asia region by 2020, which has since been extended to 2023.
A disease eliminated when the annual incidence is reduced to less than 1 case per 10,000 people at the sub-district or block level. Eradication would mean there are zero cases.
Integrated control strategy in Vaishali district has helped drastically reduce Kala-azar cases.
Community awareness campaigns:
The population susceptible to the disease need to be made aware of suitable behavioural changes that could help prevent the spread of the disease and also help improve the immunity in the susceptible population.
Chemical-based vector control:
Once a person is diagnosed with VL, indoor residual spraying was done at his house and at the neighbouring houses within 500 metres.
Though the disease is not contagious, the infected sand fly may be present in the area and the chemical spray will help kill them.
Sustained monitoring of active cases – track, test, and treat strategy – in the hotspot region is a crucial aspect of the integrated strategy. This would involve mapping of the case distribution and early case detection.
GIS-based mapping, and case data management and spatial visualisation systems would aid in the disease monitoring phase and help in the proper implementation of control strategies.
Human resource management:
Hospital staff and medical doctors in these regions were trained. Nearly 2,500 ASHA workers and 1,000 field workers were also trained.