Regional strategic framework for elimination of kala-azar from the South-East Asia Region (2011-2015)
The preparatory phase for the elimination of kala-azar from South-East Asia is nearing completion. The emphasis is now on the attack phase which will focus on the endemic villages and through the primary health-care units. This will include actively finding kala-azar cases and performing rapid point-of-care diagnosis and treatment with a single dose of liposomal amphotericin B at the primary health-care unit. This will be the most effective way to rapidly reduce the kala-azar burden, transmission and the duration of hospital stay. Sandfly vector control will be implemented using integrated vector control management and the recently developed monitoring and evaluation toolkit to improve the performance of existing vector control strategies. The consolidation phase will begin when total coverage by spraying has concluded i.e. at the end of the attack phase. This phase will end after the period of three years of active surveillance has shown no increase in the incidence rate at district and subdistrict level in endemic countries. During this phase, surveillance against re-emergence of kala-azar will be the responsibility of the disease control programme in the country until kala-azar is no longer a public health problem. This multiple approach strategy will have a major impact on reaching the elimination target of less than one case in 10 000 by 2015 in South-East Asia.