It is highly contagious disease primarily of cattle, camels, sheep, goats and swine and secondarily in other animals and man
Characterized clinically by inflammation of the genital organs and fetal membrane, abortion with retained placenta and a subsequent high rate of infertility.
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
Brucellosis is an important re-emerging zoonosis with a worldwide distribution, in India was recognised first in 1942.
It is still an uncontrolled serious public health problem in many developing countries including India. Brucellosis in India is yet a very common but often neglected disease.
LSD outbreak take place in India & Bangladesh & now Pakistan's Ministry of Livestock & Dairy Development alerts farmers & vets regards this disease.
I'll tell these signs in detail in You tube channel 'Vets Hub'
Treatment & control
It is highly contagious disease primarily of cattle, camels, sheep, goats and swine and secondarily in other animals and man
Characterized clinically by inflammation of the genital organs and fetal membrane, abortion with retained placenta and a subsequent high rate of infertility.
local names, definition, etiology,epidemiology lifecycle, pathogenesis, clinical findings, necropsy finding, diagnosis,treatment, control and prevention
Brucellosis is an important re-emerging zoonosis with a worldwide distribution, in India was recognised first in 1942.
It is still an uncontrolled serious public health problem in many developing countries including India. Brucellosis in India is yet a very common but often neglected disease.
LSD outbreak take place in India & Bangladesh & now Pakistan's Ministry of Livestock & Dairy Development alerts farmers & vets regards this disease.
I'll tell these signs in detail in You tube channel 'Vets Hub'
Treatment & control
Infections spread from animals to human are called zoonotic infections.
The term zoonos is’ Derived from the Greek
ZOON (animals) and NOSES (diseases)
Pathogens shared with wild or domestic animals cause more than 60% of infectious diseases in man.
Protozoa and Helminth Parasites ppt by Dr.Prince.C.PDR.PRINCE C P
PPT prepared by :Dr.Prince.C.P
Associate Professor & HOD , Department of Microbiology,
Mother Theresa Post Graduate & Research Institute of Health Sciences (Government of Puducherry Institution)
Medical Parasitology is the subject which deals with the parasites that infect human being, the diseases caused by them, clinical feature and the response generated by human being against them. It's also concerned with the various methods of their diagnosis, treatment and finally their prevention & control.
An ova or cyst or egg is detected by microscopic evaluation of a stool sample that is used to look for parasites that may infect the lower digestive tract, causing symptoms such as diarrhoea. The parasites and their eggs (ova) are shed from the lower digestive tract into the stool
Stool examination (Microscopic) is performed for the diagnosis of following parasitic infections
1. Protozoa • Entamoeba histolytica • Giardia lamblia • intestinal coccidian parasites (i) Cryptosporidium parvum (ii) Cyclospora (iii) Isospora • Balantidium coli
2. Helminthes • nematodes: (i) Ascaris lumbricoides (ii) Trichuris trichuria
(Iii) hookworm • Ancylostoma duodenale • Nectar americans (iv) Strongyloides stercoralis
Cestodes: (i) Taenia spp • T. Saginata • T.Solium (ii) Hymenolepsis nana (iii) Enterobius vermicularis
Food-borne diseases, including food-borne intoxications and food-borne infections, are terms applied to illnesses acquired through consumption of contaminated food, and are also frequently referred to as food poisoning.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
2. Zoonoes also known as zoonosis, and zoonotic diseases are
infectious disease caused by bacteria, virus, and parasites
zoonos that spread between animals and humans.
3. A zoonotic parasite is a parasite that can be transmitted
between animals and people. Humans are not the primary
host, so the zoonotic parasite will act differently in humans.
Zoonotic parasites cause health problems in humans that
range from those that are minor to the very serious
4. There are three types of Parasitic Zoonoses :-
1. Taeniasis
2. Hydatid Disease
3. Leishmaniasis
5.
6. •
A group of cestode infections which are important
zoonotic diseases. Two parasites of importance in
taeniasis are Taenia saginata and T. solium. These are
classified as "cyclo-zoonoses" because they require
more than one vertebrate host species (but no
invertebrate host) to complete their developmental
cycles.
7. Taeniasis is an infection within the intestine by adult
tapeworms belonging to the genus Taenia. It is mainly
caused by eating contaminated pork or beef
8. • This parasite is virtually global in distribution, wherever beef is
eaten. Highly endemic regions (prevalence rates exceeding 10
per cent) exist in some African countries south of the Sahara, in
Eastern Mediterranean countries and in parts of USSR. There is
a moderate prevalence in Europe, in most of the Indian
subcontinent, Southern Asia, and in Japan.
• T. solium infection is endemic in many countries of Latin
America, Africa and Asia as well as in some parts of Europe and
the USSR (2). It is endemic in India, and has been widely
reported
12. • T. saginata and T. solium pass their life cycles in two hosts.
In man, the adult parasites live in the small intestine.
• The adult T. saginata measures 5 to 12 metres in length,
and may be up to 24 metres; T. solium measures 2 to 6
metres.
• The larval stage of T. saginata (C. bouis) mainly occurs in
cattle. The pig is the main host for the larval stage of T.
solium (C. cellulosae) but man may also be infected.
• The adult stages of T. saginata and T. solium may persist
for several years in infected humans
15. These infections are acquired :
1. Through the ingestion of infective cysticerci in undercooked
beef (T. saginata) or pork (T. solium).
2. Through ingestion of food, water or vegetables contaminated
with eggs.
3. Reinfection by the transport of eggs from the bowel to the
stomach by retroperistalsis.
19. 1. Stool Examination
2. Immunological Test (Detect the presence of cysticerci)
3. MRI
4. CT Scan(To detect cysticerci in various organ)
5. Blood Test
20. The methods usually employed for control are :
• Early detection
• Treatment of infected persons.
• Meat inspection.
• Health education.
• Adequate sewage treatment and disposal.
• By the proper housing and feeding of pigs.
21. • Thorough cooking of beef and pork is the most effective method
to prevent food-borne infections.
• Improvement of living conditions, especially safe treatment of
sewage used for farming, should be aimed at.
• Education of the public to prevent pollution of soil, water and food
with human faeces, and washing of hands before eating and after
defecation, are important health educational messages.
22. • Praziquantel is given in a single dose of 10 mg/kg. body wt. It
achieves cure rates of about 99 per cent.
• Niclosamide 2grams empty stomach.
Note :- The tablets must be chewed thoroughly and swallowed
with water. Eating may be resumed after 2 hours.
• For the treatment of T. solium, give moderate purgative 2-3
hours after the drug to rapidly eliminate segments and eggs
from the bowels.
23.
24. Hydatid disease is a zoonoses a group of cestode
infections which are important zoonotic diseases of
man. The disease in man is caused by the metacystode
stage (infective larva) of the canine intestinal tapeworm
Echinococcus; the adult worms are found in dogs and
other carnivores.
25. Hydatid disease (also known as hydatidosis or
echinococcosis) is a potentially serious, sometimes fatal,
condition caused by cysts containing the larval stages of
the Echinococcus granulosus (E. granulosus) tapeworm
(Dog Tapeworm).
26. • In recent years, hydatidosis has been recognized as a
public health problem of nearly global dimensions.
• It is found in all sheep-raising countries, e.g., Australia,
New Zealand, Tasmania, Middle East countries, Turkey,
Greece, USSR, Cyprus, Latin America and the Far East etc.
• In India where the highest prevalence is reported in
Andhra Pradesh and Tamil Nadu than in other parts of the
country.
• The prevalence of the disease is reported to be high in
food animals in India.
27. Agent
(E.granulosus, E.multilocularis, E. Oligarathus, E. Vogeli)
Host
• Dogs
• Catss
• Shepheards and their
families
• Shoe makers
Environment
• Low temperature
• Heavy rainfall
• High humidity
28. • (a) E. Granulosus : It is of worldwide distribution, is for the
most part, maintained in the domestic transmission cycle
involving the dog as final host. In man the infective larva
causes hydatidosis.
• (b) E. multilocularis : It is restricted to the northern
hemisphere. It has been detected increasingly in various
countries (e.g. Iran, Turkey}. In man, the metacystode causes
the "alveolar" type of the disease.
• (c) E. oligarthus: a species occurring in Central and South
America is suspected to cause disease in man.
• (d) E. Vogeli : a species occurring in Central and South
30. • The main hosts are Sheep and Dogs.
• Human infection is acquired usually in childhood through
contact with infected dogs.
• Hydatid disease is an occupational disease of certain groups,
e.g., shepherds and their families in endemic areas and shoe-
makers.
31. • Climatic conditions including low mean annual air temperature.
• High mean annual rainfall and high humidity of the soil.
32. • Human infection occurs by ingestion of the eggs of
Echinococcus inadvertently with food.
• Unwashed vegetables or water contaminated with faeces from
infected dogs.
• Infection can also take place while handling or playing with
infected dogs, e.g., hand to mouth transfer of eggs.
• Inhalation of dust contaminated with infected eggs.
• Carnivores get infected by eating viscera containing hydatid
cysts.
33. • Incubation period is variable from month to years, depending
upon the numbers and location of cysts and how rapidly they
grow
37. 1. There is no specific treatment excepting surgical removal of
cysts which is not without considerable risk in as much as the
accidental penetration of one of the cysts can lead to
anaphylactic shock which may prove fatal.
2. Mebendazole (Vermox) has been tried and found very
effective in mice. It may well become the drug of choice.
38. 1. Preventing dogs from gaining access to raw offal at slaughter
houses and on farms.
2. Control of slaughter houses, proper meat inspection and
destruction of infected viscera.
3. This involves eliminaion of stray dogs, drastic reduction of dog
population, an effective dog-registration system; surveillance of
dogs based on periodic stool examinations after administration of a
teanifuge such as arecoline hydrobromide, followed by the isolation
and treatment of infected animals with praziquantel. A single oral
dose of 5 mg/kg of body weight will remove all adult worms from
the dog.
4. Health education of the public particularly butchers, dog owners,
animal breeders and shepherds is the basis of effective prevention.
40. Leishmaniasis are a group of protozoa! diseases caused by
parasites of the genus Leishmania, and transmitted to man by
the bite of female phlebotomine sandfly. They are responsible
for various syndromes in humans kala-azar or visceral
leishmaniasis (VL), cutaneous leishmaniasis (CL), muco-
cutaneous leishmaniasis (MCL), anthroponotic cutaneous
leishmaniasis (ACL), zoonotic cutaneous leishmaniasis (ZCL),
post-kala-azar dermal leishmaniasis (PKDL), etc.
41. A tropical and subtropical disease caused by
leishmania and transmitted by the bite of sandflies. It
affects either the skin or the internal organs.
42. WORLD :-
• Leishmaniasis is endemic in many countries in tropical and
subtropical regions, including Africa, Central and South
Americas, Asia and the Me.diterranean region.
• More than 90 per cent of all cases of cutaneous leishmaniasis
occur in Afghanistan, Algeria, Brazil, Colombia, the Islamic
Republic of Iran, Peru, Saudi Arabia and the Syrian Arab
Republic.
• About 200,000-400,000 cases of kala-azar (visceral
leishmaniasis) are reported annually worldwide. Six countries,
namely India, Bangladesh, Brazil, Nepal, Ethiopia, South Sudan
43. INDIA :-
• Kala-azar is endemic in 52 districts in Bihar (31), Jharkhand
(4), West Bengal (11) and Uttar Pradesh (4). About 130 million
population is at risk of the disease. The present situation is
shown in Table 1.
TABLE 1
44. Agent
(Leishmania donovani, L. Tropica, L. braZiliensis)
Host
• Age
• Sex
• Population movement
• Socio economic status
• Malnutrition
• Occupation
• Immunity
Environment
• Altitude
• Season
• Climate change
• Rural area
• Vectors
• Development projects
45. The leishmania are intracellular parasites. They infect and divide
within macrophages.
• Leishmania donovani is the causative agent of kala-azar.
• L. tropica is the causative agent of cutaneous leishmaniasis.
• L. braziliensis is the causative agent of muco-cutaneous
leishmaniasis.
A. Reservoir Of Infection:-
• There is a variety of animal reservoirs, e.g., dogs, jackals,
foxes, rodents and other mammals. Indian kala-azar is
considered to be a non-zoonotic infection with man as the sole
46. (a)AGE:- Kala-azar can occur in all age groups including infants below
the age of one year. In India, the peak age is 5 to 9 years.
(b)SEX:- Males are affected twice as often as females.
(c)POPULATION MOVEMENT:- Movement of population (migrants,
labourers, tourists) between endemic and non-endemic areas can
result in the spread of infection.
(d)SOCIO-ECONOMIC STATUS:- Kala-azar usually strikes the poorest
of the poor. Poverty increases the risk for kala-azar. Poor housing
and domestic sanitary conditions (e.g. LEISHMANIAS!S lack of waste
management, open sewerage) may increase sandfly breeding and
resting sites, as well as their access to humans. Sandflies are
attracted to crowded housing as these provide a good source of
blood-meal.
47. (e) MALNUTRITION :- Diets lacking protein-energy; iron,
vitamin A and zinc increases the risk that an infection will
progress to kala-azar.
(f) OCCUPATION :- The disease strongly associates with
occupation. People who work in various farming practices,
forestry, mining and fishing have a great risk of being bitten by
sandflies.
(g) IMMUNITY :- Recovery from kala-azar and oriental sore
gives a lasting immunity. During the active phase of kala-azar,
there is impairment of cell mediated immunity, this is reflected
in the negative skin reaction to leishmanin test.
48. (a)ALTITUDE : Kala-azar is mostly confined to the plains; it does
not occur in altitudes over 2000 feet.
(b)SEASON : In the past epidemics, two peaks, one in November
and another in March-April were reported. Generally there is
high prevalence during and after rains.
(c)CLIMATE CHANGES : Kala-azar is climate sensitive, and is
strongly affected by changes in rainfall, temperature and
humidity. Global warming and land degradation together
affect the epidemiology of kala-azar in many ways.
49. (d) RURAL AREAS : The disease is generally confined to rural
areas, where conditions for the breeding of sandflies readily
exist compared to urban areas.
(e) VECTORS : In India, P. argentipes is a proven vector of kala-
azar. Cutaneous leishmaniasis is transmitted by P. papatasi and
P. sergenti. Sandflies breed in cracks and crevices in the soil and
buildings, tree holes, caves etc. Overcrowding, ill-ventilation and
accumulation of organic matter in the environment facilitate
transmission.
(f) DEVELOPMENT PROJECTS: Ironically many development
projects are exposing more people to leishmaniasis. Forest
clearing, and cultivation projects, large water resource schemes,
and colonization and resettlement programmes.
50. • Kala-azar is transmitted from person to person by the bite of
the female phlebotomine sandfly, P. Argentipes.
• Transmission may also take place by contamination of the bite
wound or by contact when the insect is crushed during the act
of feeding.
• Transmission of kala-azar has also been recorded ·by blood
transfusion and is also possible by contaminated syringes and
needles
51. The incubation period in man is quite variable,
generally 1 to 4 months; range is 10 days to 2
years.
52. • High fever
• Weight loss
• Spleenomegaly
• Hepatomegaly
• Anemia
• Malaise
• Hyper pigmentation of forehead, abdomen and hand
53. • Occasional bleeding
• Weakness
• Lymphadenopathy
• Ulcers in the mouth
• Skin ulcer
• Reduced RBC Production
54. 1.Parasitological diagnosis:- The demonstration of the parasite
LD bodies in the aspirates of the spleen, liver, bone marrow,
lymph nodes or in the skin (in the case of CL) is the only way to
confirm VL or CL conclusively. The parasite must be isolated in
culture to confirm the identity of the parasite.
2. Aldehyde test:- The aldehyde test of Napier is a simple test
widely used in India for the diagnosis of kala-azar. 1 to 2 ml of
serum from a case of kala-azar is taken and a drop or two of 40
per cent formalin is added. A positive test is indicated by
jellification to milk-white opacity like the white of a hard-boiled
egg so that in ordinary light newsprint is invisible through it. If it
occurs within 2 to 20 minutes, it is said to be strongly positive.
55. 3 Serological tests :- Of the numerous serological tests available,
Direct Aggutination test (DAT), rk39 dipstick test, ELISA and the
indirect fluorescent antibody test (IFAT) are considered most
suitable. The ELISA test has a wide potential both for diagnosis
as well as for epidemiological field surveys.
• The rk39 -rapid diagnostic test is based on the recombinant k
39 protein. The test is simple to perform and yields result
within five minutes.
4. Leishmanin (Montenegro) test:- An intradermal injection of
0.1 ml of 10^6 per ml washed promastigotes of leishmania,
suspended in 0.5 per cent phenol saline or merthiolate on the
flexor surface of the forearm is given and examined after 48 to
72 hours. Induration is measured and recorded. An induration of
56. 5. Haematological findings :- These include progressive
leucopenia, anaemia and reversed albumin-globulin ratio, with
greatly increased IgG. The WBC:RBC ratio is 1:1500 or even
1:2000 (normal 1:750). ESR is increased.
57. The drug policy under Kala-azar elimination programme as per
recommendation of Expert Committee (2000) is as follows:-
A.
1. First line drugs-short-term :
a. In areas with sodium stibogluconate (SSG) sensitivity more than
90 per cent. -SSG 20 mg/kg body wt/day (maximum 850 mg/
day) intramuscular or intravenous for 20 days, if partial response
to 20 days treatment then continue for 30 days.
b. b. In areas with SSG sensitivity less than 90 per cent
Amphotericin B lmg/kg body wt intravenous infusion daily or
alternate day for 15-20 infusions, dose can be increased in
patients with incomplete response with 30 injections.
58. 2. First line drugs-long-term :
a. In areas with high level of SSG resistance(> 20%)
– Miltefosine 100 mg daily in two divided doses for 4
weeks. (2.5 mg/kg body wt/day in two divided doses).
a. In areas with SSG sensitivity > 80 per cent
–SSG IM or IV 20 mg/kg/day for 30 days. Miltefosine
100 mg daily for 4 weeks (after phase III studies completed with
proven safety and efficacy).
59. B.
Second line drugs
1. SSG failures
–Amphotericin B lmg/kg body wt, IV infusion daily or
alternate day for 15-20 infusions. Dose can be increased in patients
with incomplete response with 30 injections.
2. SSG and Miltefosine failure
–Liposomal Amphotericin B (when final results are
available with proven efficacy and safety) Treatment of PKDL : SSG in
usual dosage for kala-azar could be given for 120 days. -Repeated 3-
4 courses of Amphotericin B can be given in patients failing SSG
treatment.
60. • A new drug namely "Liposomal Amphotericin B" in dose of 10
mg, administered intravenously as a single dose therapy has
been introduced in the Kala-azar therapy. It will help. reduce
human reservior as it cures the patient with a single shot.
61. 1. Control of reservoir :-
Since man is the only reservoir of kala-azar in India, active and
passive case detection and treatment of those found to be
infected may be sufficient to abolish the human reservoir and
control the disease. House-to-house visits and mass surveys
may be undertaken in endemic areas for early detection of cases.
62. 2. Sandfly control :-
• The application of residual insecticides has proved effective in
the control of sandflies. DDT is the first choice since the vector
of kala-azar, P. argentipes is susceptible to DDT.
• Insecticide spraying should be undertaken in human dwellings,
animal shelters and all other resting places upto a height of 6
feet (2 metres) from floor level.
• DDT (two rounds per year) at the rate of 1-2 g per sq. metre is
considered sufficient to control transmission.
• Any sign of resistance in vector should lead to an immediate
change in insecticide. BHC (benzene hexachloride) be kept as a
second line of defence.
63. • Spraying should be repeated at regular intervals to keep down
the density of sandflies. For long-lasting results, insecticidal
spraying should be combined with sanitation measures, viz
elimination of breeding places (e.g., cracks in mud or stone
walls, rodent burrows, removal of firewood, bricks or rubbish
around houses), location of cattle sheds and poultry at a fair
distance from human dwellings, and improvement of housing
and general sanitation.
64. 3. Personal prophylaxis :-
• The risk of infection can be reduced through health education.
• By the use of individual protective measures such as avoiding
sleeping on floor, using fine-mesh nets around the bed. Insect
repellents (in the form of lotions, creams, or sticks).
• Keeping the environment clean.