New Delhi: India has reported less than one case of visceral leishmaniasis (VL), commonly known as kala azar, per 10,000 population, a major step towards eliminating the often fatal, parasitic disease, say official sources. The data from 2023, the first time it has reached the less than one figure across all blocks, has been recently communicated to the World Health Organization (WHO), the officials said. A disease is considered eliminated when the number of reported cases is below 1 per 10,000 people in each of the country’s blocks for at least three consecutive years.
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According to the National Vector Borne Disease Control Programme (NVBDCP), 520 cases and four deaths of kala azar were reported last year compared to 818 cases and three deaths in 2022. Around 595 people had HIV-VL co-infection in 2023 compared to 891 the previous year. An official told PTI,
India has reported less than one case per 10,000 population across all blocks in 2023. It is a major step towards eliminating kala azar. We have intimated the WHO regarding the development.
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.
The initial target year for the elimination of the disease in India was 2010. This was later extended to 2015, then 2017, and 2020.
In October 2023, Bangladesh became the first country in the world to be officially validated by the WHO for eliminating kala azar as a public health problem.
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Till now, kala azar was endemic in India in over 630 blocks mainly in four states — Bihar, Jharkhand, West Bengal and Uttar Pradesh. A few of these blocks reported over one case per 10,000 in the last decade resulting in India missing the elimination deadlines.
Much of the success of India’s fight against LV is attributed to the role of the anti-fungal drug liposomal amphotericin B manufactured by the US-based biopharmaceutical company Gilead Sciences.
The company, through the WHO, had donated 4,45,000 doses free to the country. This was then adopted in the control programme in 2013. Dr. Mitali Chatterjee, professor of Pharmacology at Kolkata’s Institute of Postgraduate Medical Education & Research (IPGMER) told PTI in November,
The availability of a single infusion of liposomal amphotericin B proved to be the game changer that VL needed; it dramatically brought down the cases.
An estimated 50,000 to 90,000 new cases of VL occur worldwide annually, with only 25–45 per cent reported to WHO.
While India looks on course to eliminate the disease, experts emphasise the importance of addressing post-kala-azar dermal leishmaniasis (PKDL) in tandem with VL to sustain elimination.
PKDL occurs in individuals who have apparently been cured of VL. Such patients develop skin lesions that are variable in location and intensity.
However, as they appear on the skin, the sand fly vector can comfortably sit on a skin lesion, take a juicy blood meal and thereafter bite uninfected individuals who will then develop VL, and so the vicious cycle will continue.
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India recorded 314 PKDL cases last year, a significant decline from 616 in 2022, according to official data. Ms Chatterjee said,
This is the cycle we need to interrupt by diagnosing and treating VL and PKDL and also insecticidal spraying in endemic areas. So PKDL cases are considered as the disease reservoir, and are strong disease transmitters.
(This story has not been edited by NDTV staff and is published from a syndicated feed.)
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which in its Season 10 is helmed by Campaign Ambassador Ayushmann Khurrana. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In a world post COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental well-being, self-care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.
