Context

Study warns Kala azar patients can be a source of infection for others in their community.

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• Researchers from the global programme, Drugs for Neglected Diseases initiative, and the International Centre for Diarrhoeal Disease Research, Bangladesh, conducted the study.
• A study has highlighted the need to keep track of patients even after they are treated successfully to see whether they develop a skin condition called Post-kala-azar dermal leishmaniasis (PKDL).
• Public health programmes normally ignore the condition since it merely develops as skin lesions in the form of rashes and nodules.
• Even though the lesions were found to contain the parasite causing kala azar, it was not fatal like kala azar. It also appears in only some patients and not all.

Highlights of the research

• As part of the trial, 47 patients were asked to keep their hands inside the cage containing laboratory-reared sandflies for 15 minutes.
• The sandflies were then analysed and the results showed that nearly 60% of the patients in the study passed on the parasites to sandflies.

Significance of the research

• Scarcity of Information: Until now, information on the role of PKDL was scarce and scattered across decades of different research initiatives.
• Importance of transmission: It is of pivotal importance for maintaining transmission of the disease in-between epidemics.
• Problem Identification: These new findings show that early treatment of patients showing the condition will be a critical element of any leishmaniasis elimination strategy.

KALA-AZAR

• It is a chronic and potentially fatal parasitic disease of the internal organs, particularly the liver, spleen, bone marrow and lymph nodes.
• It is caused by bites from female phlebotomine sandflies – the vector (or transmitter) of the leishmania parasite.
• The sand flies feed on animals and humans for blood, which they need for developing their eggs.
• The term "kala-azar" comes from India where it means black fever.
• It is also known as Indian leishmaniasis, visceral leishmaniasis, leishmania infection, dumdum fever, black sickness, and black fever.
• It spreads due to infection by the parasite called Leishmania donovani.
• Leishmania donovani is transmitted by sandfly bites in parts of Asia (primarily India), Africa (primarily Sudan), South America (primarily Brazil), Europe (primarily in the Mediterranean region) and in North America.
• According to WHO, if the disease is not treated, the fatality rate in developing countries can be as high as 100% within 2 years.

Symptoms of Kala azar

• It is associated with fever, loss of appetite (anorexia), fatigue, enlargement of the liver, spleen and nodes and suppression of the bone marrow.
• It also increases the risk of other secondary infections.

Diagnosing Kala azar

• The first oral drug found to be effective for treating kala-azar is miltefosine.
• The most common method of diagnosing kala azar is by dipstick testing. However, this method is highly problematic.