Kala Azar (visceral Leishmaniasis): Prevention, Causes, Treatment

Kala Azar is a disease that is carried by insects. Thus, is a tropical disease which occurs mostly in Asia, Africa, southern Europe. Kala Azar disease carried by insects are found along the rivers, the disease is probably caused by sandfly (Phlebotomus) which carried a parasite called visceral Leishmaniasis.

It can also be introduced into the skin through a fair piercing of the sandfly. According to scientific research, this disease is easily identified and examine under a microscope which reveals these protozoa. These microscopic parasites are said to enter the cells of the body,  especially the bone marrow, liver, spleen and blood vessels.
The disease may come on suddenly or maybe gradually.

Signs and symptoms of Kala Azar

•   This occurs with sudden onset there is usually a high fever
• Also proceed further to chills or vomiting, lasting up to two to six weeks; or vice versa.
• The spleen usually enlarges follow by the swollen of the liver.
• The patient condition apparently improves and getting worse and worse every day followed by fever and swelling of the spleen and liver.
• After some months there may be fever free followed by low persistent low-grade elevation of body temperature.
• The patient becomes thin and anaemic and with a large distended stomach or abdomen.

However, the name Kala Azar means " the black disease ". Because in many cases the skin may be peculiar to a grey colour, especially on the feet, hands, and abdomen. The hair may fall out the patient is said to have bleeding from gums and nose.

Even though the patient has the fever and a large abdomen and is weak and emaciated, his appetite remains good, his tongue will still be good,  and may continue working. The disease usually lasts for several years and the white blood cells are greatly reduced. Thus, making the patient vulnerable to infections such as bronchial pneumonia and ulcers of the mouth. According to research,  about 90 per cent usually dye of dysentery.

There is an infertile form of this disease that begins internally with fever and gastrointestinal disturbance. In a case like this not only the child's spleen enlarges but also the lymphatic glands.

According to a medical scientist, there is also a cutaneous form of Kala Azar, also known as oriental sore, in which the parasites occur in nodules or ugly ulcers of the skin or mucous membranes of the exposed parts of the body.

Diagnosis of Kala Azar

Diagnosis is made by an examination of the blood, bone marrow and tissue,  and from a puncture of the liver or spleen,  or from the ulcers of the cutaneous variety.

Treatment Of Kala-Azar 

Treatment is by means of injection of pentavalent compounds of antimony. Sodium antimony gluconate  (ethylenediamine) in a 5% solution in distilled water is given intravenously. The dosage is 0.2 gm on the first day followed by 0.3 gm daily till a total of 5.0 gms.

Oriental sore is treated in many different ways because there is no specific treatment. Neostibosan in solution is also prescribed for the purpose of treating the ulcer area and hasten to heal.  Carbon dioxide snow, x rays, cater,  excision,  injections, and ointments are all recommended by various authorities.

However, Good hygiene and good oral hygiene must be emphasized in the care of this disease and any concurrent infections such as malaria must be treated. An iron medication is indicated for the anaemia associated with Kala Azar, and the diet should be such as to supply the necessary vitamins and nourishment required by the body.

Prevention of Kala Azar 

The phlebotomus  (sandfly ) breed so in the moist dirt, cracks, crevices, sides of drains; a pile of rubbish and all kind of refuse. Therefore, it is important to keep compounds clean and walls in good condition. Dark, moist places should be ventilated and we'll dry. Spraying of all possible breeding places with flit is also recommended.

Since plants may harbour insects they should not be grown near building's,  nor creepers allowed on the walls. An animal such as ducks, chickens, cows, and pigs are also sources of infection and should not be allowed under houses or near the sleeping area or quarters.

Houses and places that have been infected should be avoided. Infected cases should be segregated at least 300 yard's away from uninfected persons.

In an area or districts that have been infected, it may be advisable to use a net while sleeping but to be effective the net must be of fine-meshed quality, fine enough to keep the sandfly from entering the net. An electric fan will keep the fly away. Insects repellent are useful when applied to the skin. A good ointment consists of three categories each of oleum anise, eucalypti, and terebinth, Mixed with one ounce of lanolin.

References

• The New Health and Longevity by A. C. Selmon a. The Oriental Watchman Publishing House, 1960. 
• msfindia india/kala-azar-leishmaniasis