On the Way to Eliminate Kala-azar
26 November 2018 I Kathmandu
Kala-azar or visceral leishmaniasis is one of the major vector borne diseases caused by leishmaniasis parasites which is transmitted to humans by the bite of an infected female sandfly. It is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia (which may be serious). If the disease is not treated, the fatality rate in developing countries can be as high as 100% within 2 years. 
The death from the disease can be reduced by early diagnosis and treatment with a single dose of medicine called Liposomal Amphotericin, which is available free of cost through World Health Organization (WHO) donation. The medicines were given to the Nepalese Ministry of Health and Population (MoHP) who distributes the doses to those in need.
The disease is a major public health problem in the South-East Asia region which affects the poorest and most marginalized people and is commonly associated with malnutrition, poor housing, and a weak immune system. Nepal has 18 districts which are endemic for Kala-azar but many other districts are reporting cases.
In the South-East Asia region, Nepal, India, Bangladesh, Bhutan, and Thailand have committed to eliminating Kala-azar as a public health problem by 2017. These countries are yet to achieve the elimination target.
To eliminate the disease countries must intensify efforts towards early case detection and complete treatment, integrated vector management, effective disease and vector surveillance as well as social mobilization and partnerships.
In the past years, Nepal has improved Kala-azar surveillance systems and early diagnosis capacity and has been providing quality assured drugs to the patients and further improvements are being made based on updated WHO guidance.
To update clinicians on early case diagnosis, effective treatment and surveillance, a symposium was also held from 22 – 23 November, organized by MoHP’s Epidemiology and Disease Control Division (EDCD), with the technical support from WHO Country Office for Nepal and the financial support from KalaCORE.
“With the strong commitment from the government and support from partners, we can eliminate the disease from Nepal’ stated Mr. Ghanshyam Pokharel, Acting Director, EDCD, during the symposium.
At the symposium, 50 treating physicians, pediatricians, and dermatologists from across the country were provided orientation by international and national Kala-azar experts on global and national situation of Kala-azar along with case diagnosis, management, outbreak investigation, and response in line with the updated national guideline on Kala-azar elimination in Nepal. Participants also receive a platform to share their experiences and challenges on managing Kala-azar and other forms of Kala-azar cases.
Sustaining the achievements, accelerating efforts, and bringing innovations are key to achieve Kala-azar elimination from Nepal.