Kala-azar and elephantiasis
BMJ 2003; 327 doi: https://doi.org/10.1136/sbmj.0312473 (Published 01 December 2003) Cite this as: BMJ 2003;327:0312473
- Sanjit Bagchi, sixth year medical student1
- 1Calcutta National Medical College, India
Terai region, in the foothills of the middle Himalayas, is a holiday haven for trekkers from all over the world. The picturesque valleys-of India, Nepal, Bangladesh and Bhutan-are also a happy hunting ground of sand flies, the deadly vectors of a fatal parasitic disease called kala-azar or visceral leishmaniasis. Those who become infected have irregular bouts of fever, substantial weight loss and anaemia. If the condition is left untreated mortality is about 100%.1
In the top five
According to an estimate by Médicins Sans Frontières (MSF), kala-azar is one of the top five neglected diseases of the world, infecting about 500 000 people and killing 60 000 people each year.23 Most deaths occur in the Terai region because people in these areas are so impoverished that they cannot afford the $150 to buy the basic sodium stibogluconate treatment. The average annual income of a person in this area is mere $200.
Moreover in recent years the parasite leishmania has become resistant to this traditional treatment, which has led to several small outbreaks in areas of north Bihar (in India) and in adjoining Nepal and Bangladesh.
Treatment is a deterrent
Because of a lack of facilities for early diagnosis, poverty, and lack of awareness in rural people the disease rarely gets treated in its initial stages. In addition, the duration of the first line treatment--a course administered daily through injections over at least three …
Log in
Log in using your username and password
Log in through your institution
Subscribe from £184 *
Subscribe and get access to all BMJ articles, and much more.
* For online subscription
Access this article for 1 day for:
£50 / $60/ €56 (excludes VAT)
You can download a PDF version for your personal record.