Kala-azar epidemic in Varanasi district, India

Abstract

Reports at the Sir Sunder Lal Hospital, Banaras Hindu University, of a large number of kala-azar cases from one particular village in Varanasi district, Uttar Pradesh, led us to carry out an epidemiological study of the situation using standard techniques. The overall prevalence and case fatality of the disease were 12.9% and 10.5%, respectively. A history of fever and hepatosplenomegaly was noted for all the cases. The case definition was the presence of parasites in bone marrow or splenic aspirate smears. The disease was more prevalent among adults, but occurred also among children. However, there was no clear linear relationship between the prevalence of the disease and age group. Kala-azar occurred among males and females, and its prevalence did not correlate significantly with income. Since the disease vector continues to be present in the study area, the health authorities should take strong steps to control the disease.The epidemiological characteristics of the kala-azar outbreak in Pandit Ka Purva, India, were investigated using standard techniques. A door-to-door survey of 518 persons in Pandit Ka Purva was carried out in November and December 1995, using a predesigned and pretested proforma. Independent variables such as age, sex, and literacy were considered in the survey. Results showed that the overall prevalence and case fatality of the disease were 12.9% and 10.5%, respectively, with a history of fever and hepatosplenomegaly noted for all cases. Culture and Giemsa staining confirmed indications of parasites in the bone marrow or splenic aspirate smears. The disease was more prevalent among adults, but it occurred also among children. However, there was no clear linear relationship between the prevalence of the disease and age group. Kala-azar was more prevalent among males, and its occurrence did not correlate significantly with income. In view of the outbreak of kala-azar in Pandit Ka Purva, it is essential for health authorities to take immediate measures to control the epidemic and prevent its spread to neighboring villages. This will necessitate the development of shorter treatment courses, the improvement of diagnostic methods, and close cooperation between universities, public health agencies, and the government.