Bill Gates to help Bihar fight kala azar

[Snowy Owl]

Bill Gates to help Bihar fight kala azar

http://www.newasiatimes.com/topstori...sp?storyid=949

NAT News Network
Posted on Monday, October 23, 2006 | at 4:20:53 PM IST

As hundreds of people, mostly poor, suffer from the deadly kala azar ( black fever) in Bihar, the World Bank and Bill & Melinda Gates Foundation are eager to fund the kala azar control and eradication programme.

Currently 31 out of 38 districts in Bihar are in the grip of the disease.

The state government's own estimate said over 25,000 people are suffering from kala azar.

Dengue deaths in Delhi became a national issue but deaths due to kala azar which has been regularly reported in rural Bihar hardly make any news.

The main victims of this disease belong to poor Dalit castes, like Musahars, and backward castes.

Landless Musahars and other backward castes have been forced by socio-economic reasons to live in unhygienic conditions that made them easy prey to the dreaded disease.

Some kala azar experts have given it the name of poor man disease.
According to sources in the state government, the World Bank has shown keen interest to fund the kala azar control and eradication programme."
Bill Gates foundation also want to join hands to eradicate kala azar."
The foundation has decided to fund the battle against kala azar." Dr C P Thakur, a reputed expert of Kala azar said.

Thakur, a former Union minister said that foundation was in touch with concerned department of government of India to reduce suffering of people.

A World Bank team will visit Bihar's worst kala azar hit districts of Muzaffarpur and Vaishali in north Bihar shortly to review the situation, official sources said.

In Bihar only a few districts including Gaya, Kaimur, Rohtas, Aurangabad, Nawada ,Jamui and Banka remains free from kala azar till date.

Ironically, for over ten years the blame game over kala azar is going on between the Centre and state government. Both blamed each other for failure to check the disease.

Lack of funds, supply of DDT and apathy of the administration pushing more and more people to death due to kala azar in this impoverished state.

Kala azar -- medically known as Visceral Leishmaniasis - is a vector-borne disease and is characterised by fever, weight loss, swelling of spleen and liver and anemia that could lead to cardiovascular complications.

[AlaskaDenise]

Re: Bill Gates to help Bihar fight kala azar

This appears to be a largely preventable disease, by eliminating infections in reservoirs - cattle, dogs, humans, etc.

http://www.who.int/zoonoses/diseases/leishmaniasis/en/

Leishmaniasis

<TABLE cellSpacing=0 cellPadding=0 width=213 align=right border=0><TBODY><TR><TD class=iright> </TD></TR></TBODY></TABLE>
Leishmaniasis is a group of diseases caused by several species of the genus Leishmania (protozoa). Sand flies are primarily infected by animal reservoir hosts, but humans are also a reservoir for some Leishmania species. Sand flies ingest a form of the parasite when they feed on animal or human blood. In the sandfly transformation to another form takes place and by a bite of this infected sandfly, humans get infected.

Leishmaniasis are spread in large parts of Central and South America, Africa, Asia and the Mediterranean. Cutaneous leishmaniasis (with ulcers on the skin) is a zoonosis in most of the cases (only one species, L. tropica, is anthroponotic). The most important animals in the spread of cutaneous leishmaniasis to humans are rodents and hyraxes. Humans are susceptible hosts who acquire the infection when they enter enzootic forest areas for occupational purposes or due to a process of synanthropy of wild reservoirs to peridomestic habitats.
<!-- IN: //inset.mc$text = \undef;--><TABLE cellSpacing=0 cellPadding=0 width=197 align=right border=0><TBODY><TR><TD class=insetbg>:: Leishmaniasis fact sheet
:: WHO leishmaniasis site
:: WHO tropical diseases

</TD></TR></TBODY></TABLE>

Visceral leishmaniasis (which affects some of the internal organs) can be a zoonosis too in China, the Mediterranean basin and the Americas. For this disease dogs and other canids are the main reservoirs.
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The number of new cases of cutaneous leishmaniasis each year in the world is thought to be about 1.5 million. The number of new cases of visceral leishmaniasis is thought to be about 500,000. An estimated 12 million people are presently infected worldwide.

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[AlaskaDenise]

Re: Bill Gates to help Bihar fight kala azar

http://banglapedia.search.com.bd/HT/K_0026.htm

Kala-azar (kalajar) an infectious disease caused by an intracellular flagellate protozoan Leishmania donovani, common in rural parts of the tropical and subtropical countries of the world. The disease, also known as visceral leishmaniasis, is characterized by lesions of the reticulo-endothelial system, especially the liver and spleen, and is often fatal. Children are more susceptible to this disease. Kala-azar is transmitted to man by the bite of the infected female Phlebotomus sandfly. The incubation period is generally 2 to 6 months.

Kala-azar has been a public health problem in the Bengal moribund delta region since the early eighteenth century. It obtained an epidemic form in the late 18th and early 19th centuries. Due to Kala-azar, Burdwan and some other districts of West Bengal were losing population. Many people deserted the Kala-azar afflicted areas and move to East Bengal. The problem became a serious threat in late 19th century due to construction of railways and consequent deterioration in the natural drainage system.

As a collateral effect of DDT spraying under the Malaria Eradication Programme (MEP), incidence of Kala-azar in Bangladesh almost disappeared at one point, because of high susceptibility of the vector sandfly to DDT. However, the disease showed resurgence in the late 70's. Following are the data on recent Kala-azar cases collected by the Directorate of Health Services:
<TABLE width="100%" border=0><TBODY><TR><TD width="33%" bgColor=#c0c0c0 rowSpan=2>Year
</TD><TD align=middle width="67%" bgColor=#c0c0c0 colSpan=2>Kala-azar cases</TD></TR><TR><TD align=middle width="33%" bgColor=#c0c0c0>Number</TD><TD align=middle width="34%" bgColor=#c0c0c0>Death</TD></TR><TR><TD width="33%" bgColor=#ccffff>1994
</TD><TD align=middle width="33%" bgColor=#ccffff>3967</TD><TD align=middle width="34%" bgColor=#ccffff>9</TD></TR><TR><TD width="33%" bgColor=#f4f4f4>1995
</TD><TD align=middle width="33%" bgColor=#f4f4f4>4214</TD><TD align=middle width="34%" bgColor=#f4f4f4>19</TD></TR><TR><TD width="33%" bgColor=#ccffff>1996
</TD><TD align=middle width="33%" bgColor=#ccffff>6813</TD><TD align=middle width="34%" bgColor=#ccffff>30</TD></TR><TR><TD width="33%" bgColor=#f4f4f4>1997
</TD><TD align=middle width="33%" bgColor=#f4f4f4>8846</TD><TD align=middle width="34%" bgColor=#f4f4f4>17</TD></TR><TR><TD width="33%" bgColor=#ccffff>1998
</TD><TD align=middle width="33%" bgColor=#ccffff>7152</TD><TD align=middle width="34%" bgColor=#ccffff>24</TD></TR><TR><TD width="33%" bgColor=#f4f4f4>1999
</TD><TD align=middle width="33%" bgColor=#f4f4f4>7717</TD><TD align=middle width="34%" bgColor=#f4f4f4>23</TD></TR><TR><TD width="100%" colSpan=3>Source M&PDC section under Directorate of General Health Services</TD></TR></TBODY></TABLE>
Most of these cases were reported from greater Mymensingh,Rangpur, Rajshahi, and Comilla districts. Cases of Kala-azar were also detected in Dhaka, Jhenaidaha, Patuakhali and Narayanganj districts.

According to a study conducted by the Institute of Epidemiology, Disease Control and Research (IEDCR), the disease is spreading at an alarming rate. Ten years ago, the disease was confined to some northern districts only. It has now spread to more than 30 districts. Compared to the number of patients identified and treated, most Kala-azar patients remain undetected and untreated.

The protozoan parasite gets multiplied in the bone marrow, spleen and liver. It attacks lymph nodes or the body defence system, crippling the production of anti-bodies. This leads to unusual enlargement of the liver and spleen. Kala-azar also causes pneumonia, diarrhoea, loss of weight and appetite, discomfort in the abdomen, and often nasal and gum bleeding that may lead to death. Although there are several methods of detecting the Kala-azar parasite, the most reliable one is the direct agglutination test (DAT). The test is very expensive and in Bangladesh only five laboratories including one each at Pabna and Dinajpur have facilities for conducting it.

Phlebotomus argentipes is the recognized vector of Kala-azar in the eastern part of this subcontinent. A WHO report indicates that Kala-azar is a serious public health problem in the state of Bihar and West Bengal in India. After its resurgence in some parts of Bihar in the early seventies, the disease spread to 36 districts in Bihar, and 10 districts in West Bengal. There were 17,806 cases with 72 deaths till 1986, which rose to 77,102 cases with 1,419 deaths in 1992 in Bihar and West Bengal; at least 17,429 people were attacked and 255 of them died of the disease in 1997.

The sandfly breeds in soil with sufficient moisture and organic debris. It is found in cracks and crevices of dwellings and floors of cattle sheds. The larva takes about 20 days to 1.5 months to reach the adult stage depending upon temperature and availability of food. The female sandfly takes the blood of mammals. It can not fly but hops, is nocturnal in habit, and rests in humid, dark areas. High humidity favours the fly. Adult longevity is about two to four weeks depending upon prevailing environmental conditions.

There are no regular Kala-azar vector control activities in Bangladesh. Areas with large number of cases and outbreaks are sometimes sprayed with DDT as the vector sandfly is still found susceptible to DDT. In some areas insecticide-treated bed nets have been tried to control Kala-azar and have been found effective. Elimination of breeding grounds of flies is helpful in reducing incidence of Kala-azar. WHO currently supports Bangladesh's programme to control the incidence of this disease. It includes: (i) indoor residual insecticidal spray twice annually to interrupt transmission of the parasite, (ii) early diagnosis and complete treatment of Kala-azar cases; and (iii) health education to create community awareness. Sodium Stiboglucona, an intra-muscular injection pushed every 20 days, has proved to be very effective in treating Kala-azar. [SM Humayun Kabir]

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