Neglected Tropical diseases

What is the issue?

Around the world, nearly 1.6 billion people are affected by a group of diseases so ignored that the term used to refer to them is called neglected tropical diseases (NTDs).

What is the disease about?

• These are a cluster of 17 diseases affecting the poorest people living in the least developed pockets.
• While some of these diseases may be unfamiliar, leprosy, kala-azar and filariasis are better known in India and being targeted for elimination.
• A disease is considered ‘eliminated’ when the prevalence rate is less than 1 case per 10,000 population size.
• The Indian government has set itself the target of eliminating kala-azar and filariasis by 2017, and leprosy by 2018.

What is government doing towards leprosy eradication?

• ICMR has produced two rapid diagnostic tests and a uniform multidrug regimen for all types of leprosy.
• This has shortened treatment duration to 6 months.
• An indigenous vaccine developed by the National Institute of Immunology, launched for the leprosy control programme.
• The vaccine, mycobacterium indicus pranii (MIP), will be administered to people living in close contact with patients.
• The vaccine offers 60% protection to people living with leprosy patients for up to 4-5 years.
• This renewed strategy aims for leprosy elimination ahead of the 150th birth anniversary of Mahatma Gandhi, in 2019.
• To eliminate leprosy, India needs to tackle the stigma associated with the disease.
• It leads to delays in diagnosis and treatment, which in turn result in continued transmission of infection within families and communities.
• In 2015-16, 118 districts in India were endemic for leprosy with a prevalence rate of more than 1 per 10,000.

How is the government tackling filariasis?

• In the case of lymphatic filariasis, better known as elephantiasis, the government is targeting a population of 600 million in 256 endemic districts with mass drug administration (MDA).
• A community-based pilot in Yadgir district of Karnataka is being done to assess the effectiveness of a three-drug combination vis-à-vis the existing two-drug regime.
• Mass administration of DEC-fortified salt to accelerate elimination of lymphatic filariasis is being tried in the Andamans.
• Ensuring that the entire target population accepts MDA needs advocacy and community engagement.

How is Kala-azar managed by the government?

• The other key intervention is for visceral leishmaniasis (VL) or kala-azar, which is transmitted through the bite of the female sandfly.
• In India, a majority of cases are reported in Bihar, Jharkhand, Uttar Pradesh and West Bengal.
• Rapid diagnostic tests followed by single day treatment now makes rapid cure possible.
• Sandflies breed on mud walls, so vector control by indoor spraying with insecticides and ultimately with improved housing can result in their control.

What could be done?

• Continued surveillance and epidemiologic data collection is necessary to ensure that the disease continues to be under control.
• Besides basic research, the discovery of new facts about a disease, vaccines and drugs along with new strategies and sustained research are needed to make an impact.
• Partnerships with diverse stakeholders are useful in creating awareness, improving case detection, treatment completion and, most importantly, managing stigma.
• Timely diagnosis and treatment access in unreached areas, focussing on the fundamentals of preventive interventions, nutrition, safe drinking water, sanitation and hygiene are essential in fast-tracking the goal of elimination.

Source: The Hindu