Kala Azar Symptoms: Understanding the role of Entomology in the fight against it

Understanding disease symptoms and treatment

Kala-Azar is a parasitic disease transmitted by sandflies, affecting the spleen, liver, and bone marrow. It is one of the neglected tropical diseases (NTDs). Its symptoms include prolonged

fever

, weight loss, loss of appetite, enlargement of the spleen and liver,

anemia

, and darkening of the skin. If left untreated, the disease typically proves fatal.

Post Kala-azar Dermal Leishmaniasis (PKDL) is a sequel of Kala-Azar, which primarily affects the skin. It occurs in a small proportion of patients long after they have recovered from kala-azar, sometimes years later.

The treatment of Leishmaniasis hinges on various factors, including the type of disease, concurrent pathologies, parasite species, and geographic location. Traditional Kala-Azar treatment involves a single dose of Liposomal Amphotericin B (LAMB). Miltefosine, administered orally for twelve weeks, is the drug of choice for PKDL cases.

How entomology can help against Kala Azar

The prevalence of Kala-Azar in India has been a persistent challenge with India carrying 18% of the global burden as of 2020. Today, as we approach a new decade in the 21st century, we have made considerable progress towards the elimination threshold for Kala-Azar but struggle with an expertise deficit in entomology. Entomological experts are specialists in the study of insects. In the context of Kala-Azar, they are instrumental in understanding the behavior of sandflies, the carriers of the disease. Entomologists play a pivotal role in identifying breeding grounds of sandflies and implementing targeted interventions.

In the late 20th century, India boosted a strong entomological system, under the leadership of pioneers such as Dr. Rajinder Pal, Dr. B. L. Wattage, Dr. N. L. Kalra, Dr. N. R. Das, Dr. Rachael Reuben, Dr. V P Sharma, Dr. P. K. Rajagopalan and Prof. M. K. K. Pillai. Their efforts not only contained diseases in humans but also safeguarded crops, ensuring food security.

However, the current number of experts falls significantly short of the estimated need for professionals. Most seasoned entomologists have entered retirement, leaving a gaping void. Fresh roles remain largely unoccupied. Despite recent appointments by ICMR, the numbers remain inadequate compared to the challenge at hand.
Reviving entomological expertise in India is now paramount. The decreasing number of seasoned entomologists might be suggestive of a lack of interest in entomology as a career. Encouragement should be extended to universities and higher educational institutions to initiate courses focusing on entomology or vector science. Given the framework provided by the National Education Policy-2020, initiating such programs is made more feasible and aligned with contemporary educational objectives. The career prospects should be made more promising, with clear paths for progression from district-level roles to senior positions. Alongside this, providing competitive compensation will not only attract new talent but also retain existing experts.
By restoring interest in entomology, we not only strengthen our defenses against Kala-Azar but also pave the way for a healthier and more resilient India.
(Author courtesy: Dr. AP Dash, Vice Chancellor, Central University)