‘Bangladesh eradicates kala-azar, India on track too but challenges remain’
NEW DELHI: Bangladesh recently achieved a major public health goal when it eradicated visceral leishmaniasis, commonly known as kala-azar, raising the question of when India would wipe out the debilitating, often fatal, parasitic disease the fight very much on but far from complete.
Challenges in sustaining the momentum of the fight persist, particularly in tackling post-disease symptoms and HIV co-infections, experts said as the LV spotlight’ swiveled’ to India.
“Disease incidence has gone down to approximately 463 in 2023 from the previous 44,533 in 2014, a 99 per cent decrease in case numbers,” said Shyam Sundar, programme director of the Kala-Azar Medical Research Centre in Bihar, one of the four states most affected by the disease.
“The spotlight is currently on India as we eagerly await its announcement,” Kavita Singh, director, South Asia, Drug for Neglected Diseases Initiative (DNDi), said.
Visceral leishmaniasis (VL) is caused by protozoan parasites transmitted by the bite of an infected female phlebotomine sand fly. It is characterised by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia. In over 95 per cent of cases, the disease is fatal if left untreated.
There are three main forms of leishmaniasis: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose and throat).
Globally, most cases occur in Brazil, east Africa and India. An estimated 50,000 to 90,000 new cases of VL occur worldwide annually, with only 25 45 per cent reported to WHO.
Confident that India is on course to eliminating the disease, experts emphasise that efforts and continued vigilance are essential to overcome the hurdles in the way of lasting victory. India recorded 286 PKDL cases from January to October this year, a significant decline from 616 in 2022.
Another big threat to VL elimination is HIV-kala-azar co-infection which has an incidence of 6 per cent of total cases. There are currently 530 cases of HIV- VL, according to data from the National Centre for Vector Borne Diseases Control.
The problem with these cases, the expert noted, is that they repeatedly relapse, adding they have to be closely followed. As soon as a relapse is detected, prompt treatment should be provided.
Union Health minister Mansukh Mandaviya said in January this year that there has been a 98.7 per cent decline in cases of kala-azar — from 44,533 in 2007 to 834 in 2022 in India.
