Early case detection, vector control and strong community engagement are keys to Kala-azar elimination in India
Kala-azar, a vector-borne disease associated with poverty, is transmitted by sandflies. It is highly fatal if left untreated in over 95% of cases. Approximately 130 million people are at risk of infection in highly endemic 54 districts across four states of Bihar, Jharkhand, West Bengal and Uttar Pradesh. The disease is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anemia. Major risk factors include malnutrition, weak immunity, migration, poor housing and sanitation conditions.
India has made tremendous progress in the elimination of kala-azar, As of 2019, 94% of the blocks have reported less than one kala-azar case per 10 000 of population at the block level. This success can be attributed to key interventions such as early case detection and its management, vector control by indoor residual spraying (IRS) and strong community engagement.
With the rapid emergence and spread of COVID-19, IRS activities were called off in many states in the last week of March due to sudden national lockdown. Lack of work forced millions of migrant workers to leave cities and head back to their native villages. Migrant workers are at-most risk, especially in endemic states. The only way to mitigate risk is to sustain essential services such as early case detection, treatment and follow-up, vector control measures, and community sensitization.
In the face of pandemic, the prevention and treatment of other killer diseases must not stop. COVID-19 can have a disruptive effect on the progress we have made in the past. “Challenges are many, but we must continue to move towards eliminating kala-azar with strong resolve,” said Payden, Deputy WHO Representative to India. “The importance of an inclusive, pro-poor strategy cannot be underscored as the disease affects marginalized communities”, she adds.
WHO Country Office for India and Ministry of Health and Family Welfare (MoHFW) has identified vector control interventions as one of the essential services to be continued . Following the decision by the government, the states were issued guidelines by the National Vector Borne Disease Control Programme (NVBDCP) to resume IRS operation in all states with strict adherence to infection prevention and control measures.
This photo story captures the vector control measures undertaken in the states of Bihar, Jharkhand and Uttar Pradesh. The resumption of IRS is planned in 5797 villages in Bihar, 1855 villages in Jharkhand and 88 villages in Uttar Pradesh. The WHO’s team of Neglected Tropical Disease coordinators are engaged to ensure the quality of the interventions through supervision of the activities. WHO is also providing technical support for the capacity building initiatives of the frontline workers.
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