Abstract
In India, more than 1,00,000 people are affected every year by Visceral Leishmaniasis (VL). VL is a chronic and fatal disease caused by Leishmania donovani parasites which are transmitted by infected female sand flies, Phlebotomus argentipes. Ninety percent of total cases of the world are reported from India, Bangladesh and Sudan. Several districts of the state Bihar show the occurrence of VL. This is 40-50% of the world cases and 90% of the cases in India. Conversely, information on epidemiology of kala-azar in India remains scanty due to inadequate studies about the various risk factors associated with VL. The present review contributes to the study of the number of cases, deaths, prevalence and incidence caused by VL, spatial distribution, basic epidemiologic features, the vector biology, transmission of the parasite, hosts and most importantly the major risk factors viz. climatic, the physical and biotic factors, the socio-economic conditions, the environmental factors, deforestation due to urbanization, domestic animals and the living standard. For this study we chose five states in India; Bihar, Uttarakhand, Uttar Pradesh, Jharkhand and West Bengal. The study period was from 2010-2017. A decreasing trend was observed in the number of incidences, cases and deaths. But on the contrary, the Post Kala Azar Dermal Leishmaniasis cases (PKDL) showed an increasing trend. The Gram Pradhans (Heads of Villages) and the villagers were also questioned regarding the associated risk factors viz. housing conditions- kaccha (mud) houses, poverty, use of bed nets, cleanliness, damp floors, cooking fuel, vegetation, the rearing of the domestic animals etc. The study suggests that the control measures have been effective in suppressing/eradicating VL but seeing the PKDL trend it also leaves a suspicion that apart from P. argentipus some other flies may also be playing the role as vectors in the transmission of VL. To decrease the transmission of Leishmania donovani and to achieve the goal of total eradication of VL from India in near future, a better understanding of the biology underlying transmission and disease with the major risk factors is the pressing need.
Highlights
Visceral leishmaniasis is a chronic and potentially fatal parasitic disease of the viscera which affects the organs due to the infection by Leishmania donovani
It is mainly reported from six countries namely Bangladesh, Brazil, Ethiopia, India, South Sudan and Sudan [10, NVBDCP-website] and 90% of these occur in India, Nepal, Bangladesh and Sudan [3] while it has been reported that north eastern region of India, southern region of Nepal and eastern and central division of Bangladesh harbor an estimated 67% of the global Visceral Leishmaniasis (VL) disease burden [NVBDCP-website]
Visceral Leishmaniasis, known as Kala-Azar (KA) in the Indian subcontinent which is prone to the occurrences of chronic Visceral Leishmaniasis (VL) or Kala-azar and is one of the major causes of morbidity and mortality creating a significant impediment to human
Summary
Visceral leishmaniasis is a chronic and potentially fatal parasitic disease of the viscera which affects the organs due to the infection by Leishmania donovani. It is important to note that this disease was not endemic in the past in this region [7, 8, 9] It is mainly reported from six countries namely Bangladesh, Brazil, Ethiopia, India, South Sudan and Sudan [10, NVBDCP-website] and 90% of these occur in India, Nepal, Bangladesh and Sudan [3] while it has been reported that north eastern region of India, southern region of Nepal and eastern and central division of Bangladesh harbor an estimated 67% of the global VL disease burden [NVBDCP-website].
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