Causes and risk factors
Kala Azar is caused due to the bite of the sandfly which is infected with the leishmania parasite. There are 20 such leishmania species that can cause infection. However the most common species causing kala azar are Lesihmania Donovani and Leishmanian Infantum.When the sandfly bites the human being it injects the infective stage, metacyclic promastigotes into the human body. The promastigotes transform into the amastigotes. They invade the cells multiple and affect the other cells of the boy. When the sandfly bite this infected human being along with blood the amastigotes enter into the body of the sandfly. The amastigotes again transform into the promastigotes, they divides into the gut and again reach the proboscis ready to infect, thus continuing the cycle. The infection is more prevalent in areas of poor hygiene and damp places where the sand fly can thrive. Low immunity and malnutrition increases the risk for infection.
Clinical presentation
There are three main types of Leishmaniasis -mucocutaneous, visceral and cutenous.
Visceral form of Leishmaniasis is known as kala azar. It is severe and life threatening infection. This form is particularly caused by Lesihmanian Donovani and Lesihmanian infantum. The parasite infects the reticuloendothelial system of the body. In this infection the vital organs of the body are affected and the infection is characterized by fever, weight loss, swelling of liver and spleen. The fever is remittent or intermittent kind. The number of red blood cells decrease along with low WBC and platelet count. Enlargement of lymph nodes occurs. Post kala azar dermal Leishmaniasis is also commonly seen. It is characterized by development of skin lesion which is patiruclarly seen on face. Nodules, pustules or macules or papular eruptions are seen.
Investigations
Diagnosis is confirmed on the basis of the symptoms narrated by the patient and on the basis of physical examination carried out by the doctor. Blood cultures along with serological test (rapid diagnostic test) and aldehyde chopra test helps in confirmation of the disease. Microscopic examination of the tissues along with blood test for antibodies can also be done. Dipstick testing can also be done, however this method is still not so effective in kala azar.Certain other routine test can also be advised.
Treatment
Administration of oral or intramuscular injection of medications namely Antimony containing compounds and antibiotics are the first line of treatment. In severe cases the person is hospitalized and appropriate treatment is given. Along with this certain preventive measures needs to be implemented. Avoid outdoor activities especially from dusk to dawn; wearing of long sleeved clothes, use of repellents etc are certain preventive measure one can adopt.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up the symptom. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
Facts and Figures:
As per WHO over 90% of visceral leishmaniasis cases occur in six countries: Bangladesh, Brazil, Ethiopia, India, and South Sudan.
Kala azar is endemic in 47 countries.
