Review looking at the current approaches and challenges in leishmaniasis control.
A document produced by the Ministry of Health in South Sudan, with the support of WHO and UNICEF as well as other national and international partners. It contains the recommended algorithms for investigating suspected cases of VL, PKDL and possible VL relapse, as well as details on diagnostic procedures and associated forms the MoH requires to be completed.
This website collates the treatment guidelines for General Hospitals, Primary Hospitals and Health Centres in Ethiopia.
Kala-azar health education film
A set of IEC/BCC activities have been designed to reach the most marginalized and vulnerable sections of the community in the endemic villages of Bihar, Jharkhand and West Bengal as per the BCC strategy for Kala-azar elimination developed by New Concept Information Systems (NCIS) with support from UK aid-funded KalaCORE consortium. The implementation of IEC/BCC activities was initiated in 2015, across seven high endemic districts of Bihar where Synthetic Pyrethroid (SP) was introduced during Round 2 of Indoor Residual Spray (IRS) in the state. Learnings from the pilot phase went a long way in strengthening the process of development of a Detailed Implementation Plan (DIP) for Phase 2 carried out in Bihar, Jharkhand (February 2016-March 2017) and West Bengal (April 2016-December 2016) and subsequently, Phase 3 of the project being currently implemented in Bihar and Jharkhand.
One of the most important activities for community mobilisation and sensitisation towards Kala-azar is called a Group Communication (GC) session in which trained teams in pairs of BCC-Fs (Behaviour Change Communication Facilitators) conduct GC sessions using the film developed for the sessions in identified villages – with the key objective of providing information on Kala-azar to the community and bringing about community level action and behaviour change for ensuring early diagnosis, treatment and IRS in the entire village.
The film on Kala-azar was scripted to cover different aspects around the disease like its symptoms, myths and misconceptions, treatment process and prevention through Indoor Residual Spray (IRS), process of diagnosis and treatment and PKDL. The storyline of the film is based on a village scene where Tukkebaaz, who is a humorous character and loves to dabble in poetry and his friend visit the Mukhiya’s (village head) house and get to know about cause of spread of Kala-azar during the discussion. They are joined by the ASHA (frontline community health worker). All the community members get together to discuss about the disease and pledge to take preventive actions at the end. The characters include real-life community members and key influencers like Mukhiya, ASHA, school teacher, adolescent girls and boys, men and women in the village. This creates an instant connection for the audience and they take interest in the story.
The treatment of the film was finalised to capture the local flavor of the place like local dialect, dressing sensibilities, cultural traditions etc. creating an appeal amongst the audience, the village community members. This helped them to relate with the story presented in the film easily. A group of local street theater actors were chosen to enact the roles and they were oriented by the director of the film in a two-day orientation workshop in Muzaffarpur, Bihar. This was done to make the film look more authentic and closer to the cultural reality of the target audience.
The film is of 17-minutes duration with three break points in which a set of 4-5 questions pertaining to the storyline and the issues being discussed about Kala-azar through the characters in the film are raised. For instance, the first break-point caters to an introduction to Kala-azar and its causes; the second break-point addresses the prevention of KA through IRS, what all problems generally one faces during IRS and how to manage these; the third break-point is focused on the diagnosis and treatment process of KA. The facilitator pauses the film when these break-points appear on the screen and a detailed discussion of 8-10 minutes under each of these takes place. The aim is to make the community interact more and participate in the discussion to create awareness in them around KA.
The film, originally developed in Hindi has also been produced in different languages for the intervention states like Bengali for West Bengal and Santhali (a local tribal language in Jharkhand) for Jharkhand.
Combining epidemiology with basic biology of sand flies, parasites, and hosts to inform leishmaniasis transmission dynamics and control
Novel line of research is Leishmaniasis revealing that time can play a large role in host-parasite dynamics and affect severity of Leishmania infections.
A free course on post-kala-azar dermal leishmaniasis (PKDL) is now accessible through the free online eLearning Platform of the World Health Organization (WHO). This course on PKDL is part of a new e-learning initiative devoted to sustainable control of neglected tropical diseases.