Kathmandu, August 5

Four persons have died of visceral leishmaniasis or kala-azar in the last eight months, according to Epidemiology and Disease Control Division. It said a total of 127 people had tested positive for the disease during the period.

The four persons who died from the disease were from Kathmandu, Palpa, Jumla and Bajura.

“We chose 12 districts initially to launch a pilot project for elimination of the disease. However, we had set out to undertake the task without necessary research. As kala-azar cases are increasing we have dropped the project and are instead focusing on diagnosis to reduce deaths from the disease,” said Dr Bibek Kumar Lal, director at EDCD.

According to WHO, for the elimination of disease, there should be less than one case in 10,000 people. However, 21 cases been diagnosed in Province 1, 23 cases in Province 2, seven in Province 3, two cases in Province 4, 28 cases in Province 5, 24 cases in Province 6 and 22 cases in Province 7.

“It is unlikely for us to achieve the target of eliminating the disease within this year. So we have instead shifted our focus on detecting the cases first,” added Dr Lal. EDCD said kala-azar cases were detected in 39 districts, which include hilly areas.

Dr Anup Bastola, spokesperson for Sukraraj Tropical Infectious Disease Hospital, said, kala-azar is a vector-borne disease caused by protozoan parasite Leishmania donovani and transmitted by the sandfly, Phlebotomus argentipes.

“The disease is characterised by prolonged fever, splenomegaly, anemia, and progressive weight loss and sometimes darkening of the skin. In the endemic areas, children and young adults are its principal victims. The disease can be fatal if not treated on time,” Dr Bastola said.

Enlarged lymph nodes are frequent in Sudanese VL patients Hyper-pigmentation, which probably led to the name kala-azar (black fever in Hindi), has only been described in VL patients from the Indian subcontinent.

As the disease advances, splenomegaly can increase, causing abdominal distension and pain, which is sometimes increased by concomitant hepatomegaly.