The document provides data on cases of Kala Azar (visceral leishmaniasis) in the state of Jharkhand, India from 1999-2008. It shows the number of cases, treated cases, and deaths reported each year for various districts in Jharkhand. The data indicates a total of 476 cases in 1999 increasing to over 2,000 cases by 2003 across the reported districts. Subsequent years of data from 2006-2008 continue to show hundreds of cases annually in Jharkhand.

1. Kala Azar Data

2. JHARKHAND 1999* 2000* 2003 * Source: H& FW Ministry, GoI, June 2001 Sahebganj 200 370 263** **Regional Directorate, Patna Aug 2003 Pakur 38 0 399** ** Regional Directorate, Patna Aug 2003 Godda 238 99 1497*** Upto Dec 03 (DMO, Godda) Total 476 469 2159+

3. Kala-azar (2006, 2007) source- State Malaria Office Districts Case Treated Death PKDL SAHIBGANJ 2006 1977 1609 3 24 2007 1509 1223 8 61 GODDA 2006 2903 2456 7 4 2007 1725 1613 4 2 PAKUR 2006 1418 1371 0 0 2007 764 714 0 0 DUMKA 2006 1210 1012 1 0 2007 805 743 8 0 TOTAL 2006 7508 6448 11 28 2007 4803 4293 20 63

4. Kala-azar 4 months upto April, 2007 and upto April, 2008 (Comparative ) Year Total Under Treatment PKDL % Treatment District Case Death Treated Sahibganj 2007 414 1 264 149 19 63.77 2008 426 1 181 244 17 42.49 Godda 2007 551 1 304 246 1 55.17 2008 562 0 359 203 4 63.88 Pakur 2007 217 0 185 32 0 85.25 2008 243 0 194 49 0 79.84 Dumka 2007 323 4 221 98 0 68.42 2008 229 1 176 52 0 76.86 Total 2007 1505 6 974 525 20 64.72 2008 1460 2 910 548 21 62.33

5. Cost per patient Lip. Amphotericin B= $ 500 x 50 = Rs 25,000 Effectiveness 92% Cost per patient Amphotericin B= Rs 150 x 15 = Rs 2,250 + IV Effectiveness 95% Cost per patient Miltefosine= Rs 750 x 4 = Rs 3,000 Oral Effectiveness 94% Cost per patient Na Antimony Gluconate = Rs 180 x 5 = Rs 900 + IM Cost per patient Paromomycin = Rs x x 5 = Rs y + IM Treatment Sundar et al BMJ 2001;323:419-422 ( 25 August )

6. TDR programme of WHO Caption: Leaves from Maesa balansae, a tea-like bush which grows on hillsides. PX6518, a compound produced from the leaves of the plant shows promise as an anti-leishmania compound. Bags of leaves are sent to Hanoi, where the active compound is extracted and semi-purified. PX6518 is being developed by the Chemical Institute at the National Centre for Natural Science and Technology (Viet Nam) and Tibotec (Belgium) in collaboration with TDR. http://www.who. int /home/copyright/ Image ID: 00061220 Leishmaniasis

7. District wise Achievement (Malaria) (upto April, 2007, 2008) S. N. District Year Population Minimum Target Achievement B.S.Exam. Malaria cases Pf MBER SPR Pf% Deaths B.S.Coll. % 1 Ranchi 2007 3202448 128098 17964 14 17417 1664 443 0.5 9.55 26.62 0 2008 3276104 131044 19224 15 18759 1251 504 0.6 6.67 40.29 0 2 Gumla 2007 888000 35520 22023 62 22023 1085 857 2.5 4.93 78.99 0 2008 908424 36337 34092 94 34092 979 741 3.8 2.87 75.69 0 3 Simdega 2007 550346 22014 16198 74 16198 1832 1794 2.9 11.31 97.93 0 2008 563004 22520 12061 54 11855 1429 1220 2.1 12.05 85.37 0 4 Lohardaga 2007 425208 17008 9991 59 9991 130 75 2.3 1.30 57.69 0 2008 434988 17400 7130 41 7130 49 36 1.6 0.69 73.47 0 5 E.Singhbhum 2007 2289873 91595 20209 22 20000 525 371 0.9 2.63 70.67 0 2008 2342540 93702 34839 37 34839 718 477 1.5 2.06 66.43 0 6 W.Singhbhum 2007 1318555 52742 28068 53 21751 3349 2086 1.6 15.40 62.29 0 2008 1348882 53955 27213 50 24117 4235 2723 1.8 17.56 64.30 0 7 Saraikela 2007 936360 37454 19995 53 19138 1231 540 2.0 6.43 43.87 0 2008 957896 38316 17702 46 17702 1504 991 1.8 8.50 65.89 0 2007 2204128 88165 38905 44 38905 5971 361 1.8 15.35 6.05 0 2008 2254823 90193 25889 29 25089 3239 91 1.1 12.91 2.81 0 2007 751172 30047 18905 63 18905 507 62 2.5 2.68 12.23 0 2008 768449 30738 16294 53 16294 233 37 2.1 1.43 15.88 0 2007 1041534 41661 18418 44 18418 405 171 1.8 2.20 42.22 0 2008 1065489 42620 13450 32 13450 634 523 1.3 4.71 82.49 0 2007 1158097 46324 22525 49 21967 1052 238 1.9 4.79 22.62 1 2008 1184733 47389 20055 42 19800 698 157 1.7 3.53 22.49 0

8. District wise Achievement (Malaria) (upto April, 2007, 2008) S. N. District Year Population Minimum Target Achievement B.S.Exam. Malaria cases Pf MBER SPR Pf% Deaths B.S.Coll. % 12 Dumka 2007 1269407 50776 22913 45 22913 2063 375 1.8 9.00 18.18 0 2008 1298603 51944 23009 44 23009 1720 296 1.8 7.48 17.21 0 13 Jamtara 2007 674163 26967 9104 34 9104 1 1 1.4 0.01 100.00 0 2008 689669 27587 9417 34 9417 16 0 1.4 0.17 0.00 0 14 Garhwa 2007 1174921 46997 20333 43 20333 3352 52 1.7 16.49 1.55 0 2008 1201944 48078 18860 39 18860 3779 47 1.6 20.04 1.24 0 15 Palamu 2007 1646808 65872 75799 115 75799 6634 245 4.6 8.75 3.69 0 2008 1684685 67387 31406 47 31406 6122 203 1.9 19.49 3.32 0 16 Latehar 2007 628430 25137 20313 81 20313 3141 164 3.2 15.46 5.22 0 2008 642884 25715 19038 74 19038 3296 266 3.0 17.31 8.07 0 17 Hazaribagh 2007 2555154 102206 21971 21 21971 1465 95 0.9 6.67 6.48 0 2008 2613923 104557 34634 33 33657 1795 78 1.3 5.33 4.35 0 18 Chatra 2007 904341 36174 17517 48 17395 2436 75 1.9 14.00 3.08 0 2008 925141 37006 13024 35 11868 1520 98 1.3 12.81 6.45 0 2007 513484 20539 4987 24 4442 185 3 0.9 4.16 1.62 0 2008 525294 21012 4429 21 4315 210 0 0.8 4.87 0.00 0 2007 1306093 52244 22519 43 22519 58 8 1.7 0.26 13.79 0 2008 1336133 53445 21921 41 21921 52 23 1.6 0.24 44.23 0 2007 2619792 104792 39844 38 39844 275 85 1.5 0.69 30.91 0 2008 2680047 107202 42029 39 42029 348 104 1.6 0.83 29.89 0 2007 2006659 80266 60638 76 49833 976 130 2.5 1.96 13.32 0 2008 2052812 82112 42139 51 42139 1041 154 2.1 2.47 14.79 0 2007 30064973 1202599 549139 46 529179 38337 8231 1.8 7.24 21.47 1 2008 30756467 1230259 487855 40 480786 34868 8769 1.6 7.25 25.15 0