Kala Azar, also known as visceral leishmaniasis, poses a significant health challenge in India
India has emerged as a significant contributor to global cases of visceral leishmaniasis, commonly known as Kala Azar, with the country accounting for 11.5 percent of reported cases worldwide. According to the Union Health Ministry, the states of Bihar and Jharkhand are the most affected, together contributing to over 90 percent of the current Kala Azar cases in India. In contrast, Uttar Pradesh and West Bengal have successfully achieved their elimination targets at the block level, showcasing the potential for controlling the disease. Health Wire recently conducted an interview with Dr. R R Dutta, Head of Department of Internal Medicine at Paras Hospitals in Gurugram, to shed light on the disease’s symptoms and prevention strategies.
Visceral Leishmaniasis, or Kala Azar, is caused by the Leishmania donovani parasite and is primarily transmitted through the bites of infected sandflies. The disease affects internal organs such as the spleen, liver, and bone marrow, leading to a range of symptoms and potentially fatal consequences if left untreated.
Health Wire interviews Dr. R R Dutta to shed light on the symptoms and prevention of Kala Azar
Dr. R R Dutta explained that Kala Azar manifests as prolonged fever, significant weight loss, enlarged spleen and liver, and abnormal blood test results. Anemia, low white blood cell count, and low platelet count are common among affected individuals. Skin lesions associated with cutaneous leishmaniasis typically appear a few weeks or months after a sandfly bite, whereas visceral leishmaniasis symptoms may take several months or even years to develop.
Prevention of Kala Azar primarily revolves around avoiding sandfly bites. Dr. Dutta emphasized the importance of staying indoors, especially during peak sandfly activity hours at dusk and dawn. Wearing protective clothing such as long sleeves, long pants, and socks, and using insect repellents containing DEET are recommended to reduce the risk of bites. Dr. Dutta also highlighted the need for insecticide spraying, the use of bed nets treated with insecticides, and creating well-screened spaces to further prevent sandfly exposure.
Uttar Pradesh and West Bengal achieve elimination targets, while Bihar and Jharkhand remain hotspots for the disease
In terms of treatment, early diagnosis is crucial for effective management of Kala Azar. A combination of parasitological or serological testing, along with clinical symptoms, is used to diagnose the disease. Immediate and comprehensive therapy is necessary for all patients diagnosed with visceral leishmaniasis. Liposomal Amb is the preferred treatment option for immunocompetent patients, although alternative treatments like miltefosine, paromomycin, and multidrug therapy are also available.
India’s battle against Kala Azar requires concerted efforts to control and eliminate the disease. By focusing on preventive measures, early detection, and timely treatment, it is possible to reduce the prevalence of Kala Azar, prevent disabilities, and save lives.