• The Union health ministry said there has been a 98.7 per cent decline in cases of kala-azar from 44,533 in 2007 to 834 in 2022 in India.

• Kala-azar is considered the second deadliest parasitic killer in the world after Malaria.

• India is committed to eliminating kala-azar from the country by 2023, the ministry said.

• Health Minister Mansukh Mandaviya chaired a high-level meeting to review the status of kala-azar disease in the four endemic states of Bihar, Uttar Pradesh, Jharkhand and West Bengal.

• He said 632 (99.8 per cent) endemic blocks have already achieved elimination status (less than one case per 10,000).

• Only one block (Littipara) of Pakur district, Jharkhand is in the endemic category (1.23 cases/10,000 population).

• About 90 per cent of global cases of kala-azar were reported from eight countries: Brazil, Eritrea, Ethiopia, India, Kenya, Somalia, South Sudan and Sudan in 2021, with India contributing 11.5 per cent of total cases reported globally.

• Kala-azar was endemic in 633 blocks of 54 districts in four endemic states of Bihar, Jharkhand, Uttar Pradesh and West Bengal. It is a notifiable disease in these states.

• Currently, more than 90 per cent of the kala-azar cases are contributed by Bihar and Jharkhand. Uttar Pradesh (2019) and West Bengal (2017) states have achieved their elimination targets at the block level. 

Visceral leishmaniasis (kala-azar)

• Leishmaniasis is a neglected tropical disease affecting almost 100 countries including India. It is caused by a parasite called Leishmania, which is transmitted through the bite of sandflies.

There are three main forms of leishmaniasis:

i) Visceral - which affects multiple organs and is the most serious form of the disease.

ii) Cutaneous - which causes skin sores and is the most common form.

iii) Mucocutaneous - which causes skin and mucosal lesion.

• Visceral leishmaniasis, which is commonly known as kala-azar in India, is fatal in over 95 per cent of the cases, if left untreated. 

• It is characterised by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia.

• Kala-azar is a vector-borne disease.

• It is caused by a protozoan parasite Leishmania donovani and transmitted by the female sandfly, Phlebotomus argentipes.

• Sandflies are small insects, about one fourth of a mosquito.

• The parasite primarily infects reticuloendothelial system and may be found in abundance in bone marrow, spleen and liver.

Post-kala-azar dermal leishmaniasis (PKDL)

• Post-kala-azar dermal leishmaniasis (PKDL) is usually a sequel of visceral leishmaniasis that appears as macular, papular or nodular rash usually on face, upper arms, trunks and other parts of the body. 

• It occurs mainly in East Africa and on the Indian subcontinent, where 5-10 per cent of patients with kala-azar are reported to develop the condition. 

• It usually appears months or years after kala-azar has apparently been cured, but can occur earlier. 

• People with PKDL are considered a potential source of Leishmania infection.

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