What is Kala-azar?
The Kala Azar is also known as “Black fever“. This is because it makes hands, feet, abdomen, and face turn grayish. Kala Azar symptoms can be difficult to identify especially with light skin tone people. It is a kind of slow, advancing, and naturally occurring disease that is caused and spread by a protozoan parasite of the Leishmania genus. In India, this kind of parasite is present in the form of “Leishmania donovani”. This parasite is known to produce harmful effects on the reticuloendothelial or RES system (90% of the RES system is present in the liver) and affects the bone marrow, liver, and spleen in abundance.
There is another term that is associated with Kala-azar known as Post Kala-azar Dermal Leishmaniasis (PKDL). This condition takes place when the parasite Leishmania donovani invades skin cells, stays and develops, and shows dermal lesions. kala-azar tends to show PKDL after a few years of treatment for Kala Azar itself.
What is Post-kala-azar dermal leishmaniasis (PKDL)?
Post-kala-azar dermal leishmaniasis (PKDL) is usually a sequel of Kala Azar or also, visceral leishmaniasis. This medical condition brings symptoms like macular, papular, or nodular rash usually on the face, upper arms, trunks, etc.
- Kala Azar is the most prevalent disease in places like East Africa and the Indian subcontinent.
- At least 5-10% of people are reported to develop the deadly condition.
- PKDL takes around 6 months to one year to develop after Kala Azar is apparently cured and can also develop earlier.
- Quackery is common and a significant problem in treating deadly diseases. This makes the government set up clinics accessible to low poverty line people. However, many people still take the help of unlicensed doctors for the sake of low prices and free treatments.
- Men are more likely to develop Kala Azar compared to women.
- Kala Azar symptoms are similar in both children and adults.
- 90% of the cases of kala-azar are prevalent in states of India like Bihar. There in Bihar, the children possess the burden of 50% of the loss of disability-adjusted life years.
- If a person is having an HIV-positive condition, he or she is more likely to develop Kala Azar.
Major risk factors leading to fatal disease Kala Azar
Poverty increases the risk of parasite attack. Poor housing conditions and sanitary conditions (such as the use of utensils, proper availability of water, management of sewage, etc)may increase the prevalence of sandfly breeding and access to human beings. Crowded houses are more prone to sand flies as these are a good source of blood meal for such insects. Moreover, human behavior like sleeping on the ground, bad sanitary conditions and poor spacing issues in the house, etc can bring more risk.
Diets that lack essential nutrients like protein-energy, iron, vitamin A and zinc, increase the risk of infections and thereby cause human beings to get exposed to full-blown diseases.
Kala Azar symptoms are more prevalent in people who lead to movement without getting immune to existing transmission cycles. People may get linked to Kala Azar parasites through their occupational environment, and widespread deforestation.
The change in the effect of urbanization and the human incursion into forested areas, also pose a hidden effect on many diseases.
The parasite Leishmaniasis is climate-sensitive and can lead to many changes in the environment where human beings reside or gather.
- If there is a change in temperature, rainfall, and humidity, where it can produce strong effects on vectors and reservoir hosts. These parasites alter the distribution and influence of population size.
- small fluctuations in temperature are more prone to the developmental cycle of the parasite Leishmania promastigotes in sandflies. This allows the entry of the parasites into the areas where the disease doesn’t seem to be prevalent.
- drought, famine, and flood- these conditions can bring a huge change in any environmental conditions of state/province/country. Access to poor nutrition can bring more harmful side effects to the health of human beings.
What are the most common Kala azar symptoms?
Kala-Azar or Visceral Leishmaniasis (VL) is a kind of disease that is caused by the parasite, Leishmania donovani, and this parasite is transmitted with the help of sand flies.
The common Kala Azar symptoms are:
- persistent fever
- weight loss
- enlargement of the spleen and liver, and
There can be chances that your skin may become dry, patchy, and scaly and may lead to hair loss in the body
In people with a light skin tone, grayish discoloration of the limbs (hands or legs), feet, face, and abdomen may be seen. This is the reason, Kala Azar is known as Black fever.
- Loss of interest: Kala Azar can bring loss of interest in people and the loss of desire for doing anything. This can also bring a pale appearance, loss of weight, and weakness in the body.
- Abnormal enlargement: Kala Azar makes you produce fat only in certain body parts including the spleen, liver, and abdomen. This may happen because of the enlargement of the body organs, usually becoming non-tender and soft.
- Patchy Skin: The skin becomes dry, scaly, available, or prone to wounds, and affects the body parts like hands, feet, face, and abdomen.
- Anemia: This is the type of condition that takes place because of loss of hemoglobin or red blood cells and if the progress takes rapidly, it can make the body prone to many other diseases.
- Anemia along with emaciation (weakness): This creates typically an awkward physical state of the body and affects the person greatly.
How can Kala Azar be prevented and controlled?
Prevention and control of leishmaniasis/Kala Azar require prime attention and a combination of interventional strategies. This is because this disease tends to bring many biological changes to the body. Therefore key strategic treatment is required. The prime strategies that may help to prevent the disease are:
- Early diagnosis: This is effective and helps to prevent the prevalence of the diseases and the complete disability or bring a man near to death. Early diagnosis helps to monitor the spread or the burden of the parasite within the body. With the help and interventional strategies of WHO (World Health Organization), access to medicines in low-poverty areas is now available through donation programs.
- Vector control: This helps to reduce the transmission of the disease by affecting the number of sandflies. There are various controlled methods that are initiated by the government and these are:
- insecticide spray
- environmental management
- personal protection
- Effective disease surveillance: It is an important step that helps to monitor the prevalence of the epidemic and maintain the situation of fatality rates under the specific condition or treatment.
- Maintenance of animal reservoirs: This should be tailored according to the local situations.
- Social mobilization and Education: Bringing knowledge to the community is one of the important steps that help to prevent human behavior and bring interventional changes at the local level.
Kala azar is endemic in 76 countries and has affected 200 million people around the world with the risk of infection. There are different Kala Azar Symptoms according to the environmental conditions, effectiveness, and the side effects of the disease. There is a kind of drug called Pentavalent antimonials that is given in the case of Kala Azar with a 30-day course of intramuscular injections. With this much effectiveness and alertness, the researcher hopes to bring simple treatment regimes, improved safety methods, and reduced risk of drug resistance.