Leishmania donovani causes Kala-azar, which is a protozoan disease. The female phlebotomine sandfly carries the parasite and causes the spread of the disease from one diseased individual to the other.. Kala-Azar is a delayed local disease also known as black fever.
The name black fever represents the high number of chronic cases with a well-defined dark pigmentation of the skin. In some places, the sickness was fatal. The name “Kala” could also have meant “death” or “deadly.
The four states endemic to kala-azar are Bihar, Jharkhand, West Bengal, and Uttar Pradesh.
Clinical manifestations of kala-azar
Several clinical manifestations of kala-azar are distinctively unique-;
- Skin blisters or ulcers
- Weak immune system
- Persistent fever and weakness.
- Recurrent fever with loss of appetite,
- Pale skin
- Abnormal weight loss
- Splenomegaly or enlarging spleen
- Enlargement of the liver
- Lymphadenopathy
- Dry, flaky, and scaly skin
- Greyish discoloration of hands, feet, abdomen, and face.
- Hair loss
- Anemia
How is Kala-azar diagnosed medically?
Serology testing is the most common prevalent way of diagnosing kala-azar. However, detection of kala-azar can be done through an ICT strip or immunochromatographic test. The ICT strip test is easy, quick, requires no special equipment, and has higher sensitivity and specificity, making it a good choice for diagnosing kala-azar in the field.
There are no definitive tests for detecting kala-azar as all of them have some disadvantages. However, some techniques are very sensitive, but they are specific to only certain areas of affection.
How is Kala-azar treated?
Kala-azar has a variety of treatment options, and each has its advantages and disadvantages-:
- Pentavalent antimonials are usually the initial line of treatment, administered as a 30-day intramuscular injection course.
However, antimonials are highly toxic and can put patients in danger; those healed of kala-azar almost always obtain lifelong immunity. - The first oral therapy for this condition was miltefosine. Miltefosine had a cure rate of 95% in Phase III clinical trials.
After a decade of usage, there is evidence of decreased efficacy. In addition, it is teratogenic, and women of child-bearing age must take contraception during and for four months after therapy. - Paromomycin is one drug identified for its antileishmanial properties quite late and was adopted as a drug to cure leishmanias after that.
Conclusion
Leishmaniasis or Black fever is a slowly progressing disease marked by recurrent bouts of fever, significant weight loss, spleen and liver enlarging, and anemia. The parasite infects the reticuloendothelial system and can be seen in large quantities in the bone marrow, spleen, and liver. If the condition is not treated, the mortality rate can reach 100% in as little as two years. There are several ways of treating Kala-azar. They can administer drugs including paromomycin, miltefosine, sodium stibogluconate, and meglumine antimoniate.
References
- https://www.doctorswithoutborders.org/what-we-do/medical-issues/kala-azar#:~:text=Kala%20azar%20is%20caused%20by,need%20for%20developing%20their%20eggs
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5196405/pdf/indmedgaz72902-0037.pdf
- https://www.aimu.us/2018/01/30/kala-azar-leishmaniasis-symptoms-causes-diagnosis-management-prevention/#:~:text=Recurrent%20fever%20intermittent%20or%20remittent%20with%20often%20double%20rise%20of%20temperature.&text=Skin%20%E2%80%93%20Dry%2C%20thin%20and%20scaly,Azar%20meaning%20%E2%80%9CBlack%20fever%E2%80%9D
- https://web.archive.org/web/20130715110608/http://www.who.int/leishmaniasis/visceral_leishmaniasis/en/
- https://nvbdcp.gov.in/index4.php?lang=1&level=0&linkid=470&lid=3743
