The eradication of the dreaded disease of Kala-Azar in the country appears to be well on path, as the number of Kala-Azar cases in the country is witnessing a steady decline during the last couple of years, thanks to the efforts being taken by the Indian Council of Medical Research (ICMR) and its institution Rajendra Memorial Research Institute of Medical Sciences (RMRIMS), Patna in checking the spread of the disease by carrying out research activities for elimination of the disease in respect of epidemiological aspects as well as diagnosis, treatment and vector control.
According to the data available with the union health ministry, the number of people suffering from Kala-Azar in the country has come down drastically from 44,533 in 2007 to 20,691 in the year 2009 (till October).
The directorate of National Vector Borne Disease Control Programme (NVBDCP) under the directorate general of Health Services, Ministry of Health & Family Welfare, deals with all vector-borne diseases including Kala-Azar in the country and is the national level technical and nodal point for developing strategies and guidelines, to guide the states for Kala-Azar elimination. Research related inputs provided by RMRIMS are used by NVBDCP in evolving strategies and guidelines for Kala-Azar elimination in the country.
The National Health Policy (2002) envisaged the elimination of Kala-Azar (i.e. to reduce the number of cases to less than 1 per 10,000 population at sub-district level) by 2010. Kala-Azar elimination is an integral component of the programme on vector-borne diseases. The main strategies for Kala-Azar elimination are early case detection and completed treatment (EDCT); vector control with DDT spray; and information, education & communication (IEC) for community awareness specially during pre-spray activities. Besides, source reduction of vector is being done by constructing pucca houses for Mushar community with assistance from ministry of rural development.
Fatal, if left untreated, kala Azar is transmitted by the bite of an infected sand fly. Largely unknown in the developed world, it is a parasitic disease that affects over 12 million people worldwide. The annual incidence is estimated to be 500,000 cases, with 50 per cent occurring in India. The disease is endemic in the eastern states of Bihar, Jharkhand, Uttar Pradesh and West Bengal. In these states, it is marginalized communities living in rural poverty who bear the greatest disease burden.
The most common treatment currently used is sodium stibogluconate (SSG). However, resistance to the drug is a growing problem - especially in India, where as many as 65 per cent of patients acquire drug resistant parasites.