Elimination of Kala-azar: Where do we stand in 2011?

Abstract

Visceral Leishmaniasis or commonly known as Kala-azar is characterized by continued fever, loss of weight, anaemia and splenomegaly. The disease is endemic in Bangladesh (45 districts), India (52 districts) and Nepal (12 districts). Recently, a small focus of Kala-azar has been reported from several districts of Bhutan. Because of the unique epidemiology (man is the only reservoir, Phelobotomous argentepis sand fly is the only vector), IRS is effective as vector control and oral drug Miltefosine is available. Elimination is possible in the three countries where the disease is confined in limited areas. Recently, Single injection of Lipid amphotericin B (AmBisome) has been shown effective in 95% of cases and recommended as the first line of drug.