Can India Succeed in Eliminating Kala-azar in Near Future?

Sneha Kumari, Jugal Kishore

Abstract


Introduction: Kala-azar (KA) remains one of the most dangerous neglected tropical
diseases (NTDs) in India, despite several efforts for eliminating it by 2010.
Objectives: To assess progress towards elimination of visceral leishmaniasis from India
and to identify major challenges in the path of its elimination and to suggest remedial
measures to be undertaken to achieve the goal in future.
Methods: Various print and electronic databases were searched for finding studies on
KA.
Findings: It was found that passive surveillance leads to many missed out cases.
Improper training of private practitioners adds further to the burden of disease.
Inadequate and irregular insecticidal spray in the endemic areas increases the number
of cases. Asymptomatic and PKDL cases are not taken seriously.
Conclusion: Kala-azar is very difficult to be eradicated till strategic modifications are not
made. Indoor residual spray should be supervised strictly. There is a need for drug
compliance and omitting irregular and incomplete treatment. Asymptomatic
(population at-risk) should be screened by rK39 test by mass screening and treated with
approved drugs. Under-reporting of the KA cases should be seriously tackled. More
emphasis should be given on active surveillance of KA cases. Reporting system should
be strengthened.Candidate vaccines should be evaluated by clinical trials which, if
found effective and safe, can eradicate KA since there are no animal reservoirs of
leishmaniasis in India. Information, education and communication (IEC) material should
be widely disseminated in general public regarding its transmission, symptoms and
preventive measures.


Keywords


Kala-azar (KA), Post Kala-azar dermal leishmaniasis (PKDL), Vector control strategies, Indoor residual spray.

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