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National Institute of Communicable Diseases |
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ANNUAL REPORT 1997 |
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NICD Branch, Patna Consequent upon the resurgence of Kala-azar as a
major public health problem in North Bihar in 1970’s, the National Institute of
Communicable Diseases, established Kala-azar Unit, Patna during 1976 to carry
out research on various aspects of Kala-azar. The main objectives of the branch
are as follows: §
To
undertake in-depth studies for the resurgence of Kala-azar in Bihar. §
To
carry out detailed entomological investigations on the prevalence,
distribution, population dynamics, dynamics of disease transmission and vector
control measures thereof. §
To
undertake detailed parasitological surveys to assess the magnitude of problem
in various affected districts. §
To
carry out detailed epidemiological studies on Kala-azar. §
To
carry out studies on the zoonotic reservoir of Kala-azar. §
To
develop diagnostic techniques for the rapid detection of Kala-azar cases and
recommend suitable drug therapy. §
To
recommend suitable vector control strategy. §
To
develop trained man-power for the effective surveillance and control of
Kala-azar. Contributions made by Kala-azar Unit, Patna since its inception 1.
Faunistic
studies undertaken in Bihar revealed the prevalence of 20 sandfly sp. Phelebotomus – 5 and Sergentomyia – 15 sp. 2.
Carried
out studies on the biology, ecology, seasonal prevalence of sandfly species
viz. Ph.argentipes and Ph.papatasi. 3.
Ph.argentipes was incriminated as a vector of
Kala-azar and it was found to be susceptible to DDT 4.
Detected
the insecticide resistance in Ph.papatasi,
vector of cutaneous leishmaniasis to DDT. 5.
Dynamics
of Kala-azar transmission in time and space. 6.
Developed
vector control strategy for the spray of DDT upto a height of 6 feet to control
vector sandfly species based on vector bionomics. 7.
Kala-azar
control strategy was formulated & implemented. 8.
Developed
a media (EH9) for in-vivo cultivation of L.donovani. 9.
A
focus of cutaneous leishmaniasis was detected in north Kerala in the year 1992. 10. Development of Hissar strain of
albino mice as an experimental model for immunoprophylactic studied on
L.donovani. 11. Undertook 153 epidemiological,
entomological and outbreak investigations in various parts of Bihar, U.P. and
West Bengal. 12. A total of 2781 animals were
screened to identify the animal reservoir of Kala-azar but none was found
positive. 13. A total of 1386 Medical Officers,
paramedical Officers and WHO fellows were trained in the epidemiology &
control of Kala-azar. 14. Reported resistance to Kala-azar,
Sodium Antimony Gluconate (SAG) compound to leishmania parasite and revised
treatment schedule to be followed with the drug. 15. Published more than 60 research
papers on various aspects of Kala-azar. Routine activities, services §
Maintenance
of colonies of Ph.argentipes, vector
of Kala-azar and Ph.papatasi, vector
of cutaneous leishmaniasis for various experimental, teaching and supply purposes.
§
Maintenance
of culture of Leishmania donovani
body for research, teaching and supply purposes. §
OPD
clinic is being run for the diagnosis and treatment of Kala-azar and P.K.D.L.
cases. §
Undertakes
outbreak investigations of other communicable diseases viz. encephalitis,
meningitis, eruptive fever, choera, gastro-enteritis, diarrhoea, jaundice, etc.
Diagnostic services Serological
aldehyde tests are being carried out on routine basis and suspected Kala-azar
cases are diagnosed by bone-marrow examination and L.D. Body culture from
aspirated material. P.K.D.L. cases are diagnosed by examination the skin strip
slides for L.D. body and by raising L.D. body culture from aspirated material
from skin lesions, if any. During
the year out of 38 patients registered at OPD clinic, 14 were diagnosed as
Kala-azar cases and 3 were confirmed as PKDL cases, one case was found to be
resistant to SAG. However, all the PKDL cases responded well to SAG treatment.
Besides, haematological tests such as T.L.C., D.L.C., Hb, E.S.R., routine
examination of urine, examination of blood smears for malaria parasite etc.
were also undertaken. Sandflies
were collected from cattlesheds and human dwellings in different endemic and
non-endemic areas, their species identified and dissected to detect the
presence of flagellats i.e. Promastigote. Research Project 1. Studies on the effectiveness of
drug regimens for the control of Kala-azar and PKDL cases to Sodium antimony
gluconate compound A total
of 23 cases of Kala-azar and PKDL patients from Patna, Vaishali, Samastipur and
Gopalganj were treated with S.A.G. during 1996 and 1997. It was observed that
30 injections for the treatment of Kala-azar cases and 106 injections for PKDL
cases are required to cure the disease completely. 2. Entomological and epidemiological
investigations of Kala-azar Entomological
and epidemiological investigations were undertaken in Samastipur, Nalanda and
West Champaran districts of Bihar during September to December, 1997. The
results of the findings are given below Kala-azar
cases/deaths and vector density recorded in three districts of Bihar
Analysis
of epidemiological data in respect of Samastipur district revealed that a
declining trend after 1992 till 1995 in Kala-azar cases due to effective
chemotherapy and DDT spray. Thereafter, number of Kala-azar cases increased due
to irregular supply of SAG and discontinuation/faulty spray of DDT. The trend
of Kala-azar cases in district Nalanda and West Champaran was also almost
similar to Samastipur, however, number of Kala-azar cases/death reported in
these two districts was much less. During
the visit Ph. argentipes, vector
density was found to vary from 18 to 60 PMH in different districts which is
quite high for maintaining Kala-azar transmission. In view of the presence of
reservoir in the form of Kala-azar patients, PKDL cases and high vector density
it is utmost important to ensure regular supply of medicine for the treatment
of Kala-azar cases, and also regular and a thorough DDT spray to bring down the
vector density for the interruption of disease transmission. |
