生物学、農業、健康科学の世界ジャーナル

概要

Treatment Of Kala-Azar Cases With Miltefosine In West Bengal, India

Bhattacharya, SK, Patra P, Pal CR, Bhattacharya MK, Nayak S, Dash AP & Satpati BR

Background & objectives: Visceral leishmaniasis (VL), also known as Kala-azar in the Indian sub-continent, is endemic in Brazil, Sudan, India, Bangladesh, Nepal and Bhutan. Ninety percent of all cases in these countries occur in India, Nepal and Bangladesh. Based on the unique epidemiology and technological development, India, Bangladesh and Nepal embarked on elimination of kala-azar from the three countries. Miltefosine was recommended as the first-line drug for the treatment of VL in the programme. Concerns have been expressed of non-compliance due to long (4 weeks) treatment and possible appearance of resistance due to its long half-life. The Regional Technical Advisory Committee (RTAG) has recommended phasing out of Miltefosine use and introduce single dose lipid amphotericin B in the programme. Methods: Retrospective and published data regarding Miltefosine treatment was collected from the records of the District hospital, South 24 Parganas of West Bengal, India, “Health on the March” published by Government of West Bengal and analysed for compliance to 4-week treatment of Miltefosine and its efficacy. Results: A total of 52 (Male=31, Female=21) VL cases occurred during 2011-2013. cure rate was ~ 98% and compliance was 100%. Interpretation & conclusions: Miltefosine was found to be safe and effective drug for the treatment of VL cases, while 100% compliance to full treatment was achieved by treating the patients after hospitalization. Advantages and disadvantages of this recommendation have been discussed citing the relatively small experience in the Noth 24 Parganas district in West Bengal State, India.