Table of Contents
Kala-azar is a vector-borne disease caused by parasite Leishmania donovani, transmitted by the sand fly, more than two weeks with splenomegaly, anemia, progressive weight loss and sometimes darkening of the skin. In the endemic areas, children and young adults are its principal victims. The disease is fatal if it is not timely treated. Kala-azar and HIV co-infections have emerged as a health problem in recent years.
In 2005, Epidemiology and Disease Control Division (EDCD) of Department of Health Services formulated a National Plan for the Elimination of Kala-azar divided in it into three phases: Preparatory Phase: 2005-2008; Attack Phase: 2008-2015 and Consolidation Phase: 2015 onwards. The overall goal of the plan is “To contribute to improving the health status of vulnerable groups and at risk populations living in Kala-azar endemic areas of Nepal through the elimination of Kala-azar so that it is no longer a public health problem”. The target is: “To reduce the annual incidence of Kalaazar to less than 1 per 10,000 populations at the district level by 2015”. Expected outputs of the Plan are six related to the different components of the system that need to be strengthened in order to achieve the elimination goal. One of the outputs is to develop a functional network that provides diagnosis and case management with special outreach to the poorest.
Over the last decade, there have been some significant and advances both in the diagnosis and treatment of Kala-azar. The rK39 test kit has been accepted and introduced as a diagnostic test and Miltefosine as a first line treatment in Kala-azar except in some situations. The rK39 dipstick test kit, a rapid and easy applicable serological test has been demonstrated to have high sensitivity and specificity in validity studies conducted in the Indian subcontinent. For the first time, an oral drug-Miltefosine has proven to be efficacious in drug trials and has been registered for the use in Kala-azar.
Reduce incidence of Kala-azar to less than 1 case per 10,000 populations at district level by 2015.
- Reducing the incidence of Kala-azar in the endemic communities including the poor, vulnerable and unreached population;
- Reducing case fatality rates from Kala-azar;
- Treatment of PKDL to reduce the parasite reservoir; and
- Prevention and treatment of Kala-azar HIV-TB Co infections.