Having failed to meet the target of Kala-azar elimination by 2012, the Union Health Ministry has now shifted the treatment procedure from administering injection to an oral drug on Directly Observed Treatment (DOT) basis as is being done in curing the Tuberculosis, hoping to achieve the revised elimination goal of 2015.
The vector-borne disease which is caused by sandfly will be declared eliminated when the number of cases is reached to less than 1 per 10,000 population at the block level.
Said a senior Health Ministry official, till 2008, diagnosis of kala-azar was being done by bone marrow aspirationor splenic puncture which was possible at District hospital. This used to delay institution of treatment and allowing transmission to continue.
Moreover, injectable Sodium Stibo Gluconate (SSG) was the drug of choice for treatment of kala-azar cases till 2008 and needed hospitalisation for institution of treatment. The long duration of treatment (one month) lead to non-compliance and non-responsiveness to the drug, he explained.
But now, new oral drug Miltefosine is being provided to the Kala-azar patients in all the kala-azar endemic districts as first line treatment on DOT pattern as a supervised treatment with patient coding system for tracking, said the official.
Moreover, under the 12th Five years plan, ASHAs will be trained and fully involved to ensure complete treatment compliance with incentive of Rs 200/- per case while incentive given to the patient towards compensation for loss of wages for 28-30 days @ Rs 50/- per day during the period of treatment.
Also, indoor residual spraying (IRS) for interruption of transmission will be taken up in all the 52 endemic Districts of the country to ensure good quality spray and coverage above 80 per cent.
Around 165.4 million population is at Kala-azar risk in four states namely Bihar, Jharkhand, Uttar Pradesh and West Bengal.