Success-Stories-on-Health-Sector

ProbleM stateMent
It is a national goal to eliminate kala-azar by the year
2015. The State of West Bengal is endemic for kalaazar
and is in 3rd position in terms of the number of kalaazar
cases in the country, next to Bihar and Jharkhand. It
was felt that in order to bring down the new incidence,
the hidden cases be found out and treated, and measures
be taken to control the environmental factors to cut off
transmission chains.
PrograMMe DescriPtion
Objectives
• To find out the undetected cases of VL and PKDL and
put them on treatment.
• To strengthen control of vectors and environmental
factors to reduce disease incidence.
Actions taken
• Active case search and proper treatment: Microplans
were prepared at block level for survey and
diagnostics camps. A special drive of rapid intensive
case search (House-to-house) and diagnostic camps
(Crash Programme) were undertaken. Confirmed
cases were referred to pre-scheduled diagnostic camps
and put on treatment with an anti-kala-azar drug as
per national protocol. The new anti-kala-azar drug i.e.
inj. liposomal amphotericin-B was introduced and the
use of liposomal amphotericin was decentralised up to
the block PHC level, after necessary training of staff.
intensive iec activities were done in the villages
before the active case search.
• All the search workers, supervisors and Medical
Officers involved in the intervention were given
orientation training.
• Administrative actions: kala-azar has been declared
as a notifiable disease in the State, a State level Task
Force is constituted as per the national road map to
elimination and guidelines have been issued to the
District Programme Officers to strengthen routine
surveillance.
• Since poor housing condition is an important factor
behind sustained kala-azar transmission, an endeavour
has been taken up to improve housing in high case
load villages.
PrograMMe outcoMes
A total population of approx. 4.9 lakhs were taken up
for the case search. Out of 3324 suspected cases 259
cases (103 VL and 156 PKDL) were confirmed. The
number of blocks having annual incidence more than
the cut-off level of elimination went up from 7 in 2013 to
11 in 2014.
evaluation
In order to assess the impact of IRS, a vector survey
was done at the same place(s) before and after IRS. The
results showed a mixed picture of impact, probably due to
inconsistent quality and coverage of IRS.
conclusions/lessons learnt
To sum up we State that we have taken to fight the
disease problem at the levels of (i) the hosts, (ii) the
disease agent, (iii) the environment including the vectors
and (iv) programmatic aspects. Already we have made a
significant advancement towards reaching our goal and
are hopeful that a concerted effort will give us success in
the end game too.