India has missed December 2017 deadline announced for elimination of Kala Azar (black fever) in 2017-18 Budget by the Union Government. Elimination in this case is defined as reducing annual incidence of disease to less than 1 case per 10,000 people at the sub-district level.
In recent times endemic blocks have increased from 61 to 68 in 17 districts of Bihar and Jharkhand. The active case findings rather than actual increase in disease are main reason for increase in number of endemic blocks. Moreover, little-known skin condition called Post Kala Azar Dermal Leishmaniasis (PKDL) — a red flag for transmission of Kala Azar—also has been growing steadily over the past few years.
Reasons for missing deadline
For elimination of Kala Azar, its vector needs to be eliminated first. But it is very difficult to eliminate vector as it dwells in wooden structure and escapes various measures to kill it. The majority of houses in endemic blocks are made from wood. Hence, to stop infection transmission, pucca houses need to be built.
Kala-azar or visceral leishmaniasis (VL), also known as black fever and Dumdum fever is most severe form of leishmaniasis. It is slow progressing indigenous disease caused by single-celled parasite of Leishmania family. It belongs to Neglected Tropical Disease (NTD) family of diseases which affect poorest populations.
Its infection is transmitted by sand fly (Leishmania donovani), a blood-sucking pest, which is one-third size of mosquitoes and found in moist (humid) mud and sand and in close proximity to livestock.
It signs and symptoms include fever, weight loss, fatigue, anemia, and substantial swelling of liver and spleen. It is treatable and requires a medical diagnosis. If untreated, kala-azar can kill within two years of onset of ailment.
It is second-largest parasitic killer in world after Malaria. It is endemic to Indian subcontinent in 119 districts in four countries (Bangladesh, Bhutan, India and Nepal). India accounts for half the global burden of Kala-azar disease.