Kala-azar is a parasitic disease caused by “Leis mania donovami” transmitted by sand phlebotomies argentines.
The disease is prevalent among socio- economically poorer sections of the society poorer sections of the society living in rural areas. The person infected with kala-azar suffers from recurrent fever, loss of appetite, loss of weight and progressive enlargement of spleen. The disease is chronic and if not treated, it leads to death. Kala-azar is more endemic in Bihar, Jharkhand, West Bengal and parts of Uttar Pradesh
In view of the rising problem, organized control measures were initiated to control Kala- azar control programme in 1991 incorporating assistance in kind provided for procurement of insecticides and anti- leishmanial drugs. The National Health Policy-2002 has envisaged goal of kala-azar Elimination by the year 2010 to pursue the goal of elimination of kala-azar by the year 2010, the government of India is providing 100% support to endemic states since 2003, apart from regular technical guidance. However, the strategy for kala- azar control broadly includes 3 major activities.
(i) Interruption of transmission for reducing vector population by under taking indoor residual insecticidal spray twice annually
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(ii) Early diagnosis and complete treatment and kala-azar cases and
(iii) Health education for community awareness. The kala-azar control programmes also included timely and quality indoor spraying by DDT, complete treatment of patients as well as intensive social mobilization. For detection of Kala-azar cases, door to door visits have also been advocated.
The government of India has now decided to introduce Rapid Diagnostic Test 39 which can be used by trained peripheral health workers. The treatment of Kala-azar at present is also long and injection based which affects treatment compliance. To improve compliance, the government has decided to introduce oral drug miltetosine in the programme, particularly for remote and inaccessible areas.