Health Minister Harsh Vardhan reviews status of 'Kala Azar' in four states

As the Centre works towards eliminating diseases like Kala Azar from India by 2025, Union Health Minister Harsh Vardhan on Wednesday held a press conference to review the status of the disease with states like Uttar Pradesh, Bihar, Jharkhand and West Bengal. During the press conference, the Union Minister noted that 54 districts in Bihar, Jharkhand, Uttar Pradesh, and West Bengal were still affected by Kala Azar with sporadic cases in other states like Assam, Himachal Pradesh, Kerala, Sikkim, and Uttarakhand.

"Kala Azar is the 2nd largest parasitic killer in the world after Malaria and results in a 95 per cent fatality rate if the patients are not treated. Additionally, up to 20 per cent of the patients who are correctly treated and cured, develop a skin condition called Post-Kala-Azar Dermal Leishmaniasis (PKDL) which surfaces within months to years after treatment. These patients can contain large amounts of parasites in their skin lesions, making them an important source of transmission," Vardhan said.

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Noting the significant progress made to eliminate the disease, Harsh Vardhan revealed that as of November 2020, only 12 blocks in Jharkhand and 4 blocks in Bihar reported more than 1 case per 10,000 population. Uttar Pradesh and West Bengal had also managed to significantly achieve their elimination target.

"A risk-based stratified approach needs to be formulated with clear activities and responsibilities that come with measurable monitoring indicators. Kala Azar disproportionately impacts the people at lower socioeconomic strata of society whose houses are not sprayed often. In addition, they are unable to apply for pucca houses since they do not own land," he added. 

Three main activities to eliminate the disease were highlighted during the video conference. This includes: 

• Development of a plan for the "unreached poorest" or underprivileged sections in endemic areas.
• Leveraging of Kala-azar elimination programme within POSHAN Abhiyaan for maximum benefit at community level.
• Exploration of the opportunity of providing improved housing under the flagship program of the Prime Minister Awas Yojana-Gramin (PMAY-G). 

What is Kala Azar? 

According to WHO, Kala Azar, known as Visceral Leishmaniasis or Black Fever is the most severe form of the leishmaniases. The leishmaniases are a group of diseases caused by protozoan parasites from more than 20 Leishmania species. These parasites are transmitted to humans by the bite of an infected female phlebotomine sandfly, a tiny – 2–3 mm long – insect vector.

VL is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver and serious anaemia. If the disease is not treated, the fatality rate can be as high as 100% within 2 years, says WHO's official website. 

WHO also says, PKDL (post-kala-azar dermal leishmaniasis), a complication of VL, is mainly seen in East Africa and South-East Asia. It is characterized by a discoloured (hypopigmented) flat skin (macular) rash, combined with some slightly elevated (maculopapular) or elevated (nodular) rash, usually in patients who have recovered from VL. PKDL usually appears 6 months to 1 or more years after apparent cure of VL, but it may occur earlier or even concurrently with VL, especially in Sudan. PKDL heals spontaneously in most cases in Africa but rarely in patients in India.

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(With Agency Inputs)

(Image Credit: Twitter/drharshvardhan)