As the Government focuses its attention on containing Covid-19, death toll due to neglected disease visceral leishmaniasis, commonly known as Kala Azar has climbed to 33 till November 2021, highest in the past seven years.
As per the data available from the website of the National Centre for Vector Borne Diseases Control Programme (NVBDCP) of the Union Health Ministry, Bihar tops the list with 24 mortalities followed by Jharkhand which has reported 7 deaths. The fatalities are alarming as last year, both the States had not reported any death due to Kala Azar. Only Uttar Pradesh and West Bengal had reported three cases each last year. This year, so far no deaths have been registered in these two populated States. In the first eleven months of this calendar year, ie till November 2021, 1163 cases have been reported against over 1900 reported last calendar year.
The deaths suggest that the infection is not being treated on time. Health experts say that if left untreated, visceral leishmaniasis which is otherwise a curable disease can be fatal in over 95% of cases. It is caused by the protozoan parasite of the genus Leishmania. Its clinical manifestations include irregular bouts of fever, weight loss and anemia.
Post-Kala-Azar Dermal Leishmaniasis (PKDL) cases too have increased from 617 in 2020 to 653 till November 2021. Kala-azar is the second deadliest parasitic killer in the world after malaria. The WHO estimates that 50,000 to 90,000 people globally are infected each year. India accounts for about two-thirds of the total global cases, and Kala-azar is endemic to Bihar, Jharkhand, Kerala, Sikkim, Uttar Pradesh and West Bengal. Though its incidence in India has declined over decades, the country has missed several deadlines – 2010, 2015 and 2017 – for its ‘elimination’.
According to the WHO, poverty is an increased risk factor as is poor housing and domestic sanitary conditions (such as a lack of waste management or open sewerage). Other factors include malnutrition, population mobility and environmental and climate changes.
The only drug available against leishmaniasis, miltefosine, is rapidly losing its effectiveness because of emerging resistance to this drug due to a decrease in its accumulation inside the parasite, which is necessary for the drug to kill the parasite, say the experts.
The National Kala-Azar Elimination Programme (NKEP) has made it mandatory for all states to report the diseases, including zero cases. To compensate for loss of wages by Kala Azar and PKDL cases, the Government provides Rs 4000 per PKDL case and Rs 500 per treated KA case. Bihar and Jharkhand, in which most Kala Azar and PKDL cases occur, provide an additional Rs 6600 in compensation for wage losses.