India remains the main focus of visceral leishmaniasis (VL) disease burden in South Asia with the states of Bihar and Jharkhand continuing to be the most endemic for VL infection.
Good progress has been made towards VL elimination in India. In 2013, 13,869 cases were reported, representing a drop of over 50% from 2010. Since 2013, the absolute case-load has decreased (4,378 cases were reported in 2018). A number of factors are likely to have contributed to this drop in numbers which include significant control efforts as well as the natural epidemiological trends of VL.
The department overseeing India’s VL strategy is the National Vector Borne Disease Control Programme (NVBDCP). Major components of the strategy have been the introduction of single day AmBisome treatment and the change of insecticides. KalaCORE was responsible for rolling out AmBisome and has focused on strengthening AmBisome treatment centres. In early 2017, the NVBDCP published a new roadmap for the elimination of VL in India as a public health problem in the ‘Accelerated Plan for Kala-Azar Elimination’) (link is external).
Elimination of VL in India on the whole has not yet been fully achieved. However, at the end of 2018, 92% of total endemic blocks in India did reach the elimination target. Bihar state has also been approaching elimination, while Jharkhand facing the most challenges, falls behind, in 2018, 52% of blocks in Jharkhand reported more than one cases per 10000 population. West Bengal reported 100% of endemic blocks reached elimination target; whereas in UP, 5% of block again reported more than 1/10000 cases in 2018 after achieving 100% elimination target in 2017. As the programme has been nearing its end, KalaCORE has focused on strengthening efforts in Jharkhand, for example by providing extensive training to health workers and thus building local capacity.
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