Fighting a neglected disease: kala azar in Bihar


Kala azar (visceral leishmaniasis) is a significant public health concern in Bihar, India.  The disease is most common in agricultural villages and is almost always fatal without treatment. Doctors Without Borders / Médecins Sans Frontières (MSF) has been on the frontline of fighting kala azar for the past eight years and has treated more than 12,000 patients till date.  Photos by Matthew Smeal/MSF

Transmitted by the bite of a sand fly, kala azar is a parasitic disease that affects the poorest of the poor. Like many farmers, 55-year-old Jageshwar Rai occasionally sleeps in a cow shed which is typically unhygienic and humid, offering an ideal ground for sand flies to breed.


Girl with post kala azar dermal leishmaniasis, a recurrent but non-fatal form of kala azar that affects 5–10 per cent of patients between six months to three years after cure.


MSF staff conduct an information session about the spread and symptoms of kala azar on the river island of Raghopur, where more than 25% of kala azar cases in Vaishali district originate from.


Villagers on the river island of Raghopur listen to an information session about kala azar.



An MSF nurse prepares a single dose of LAmB, an intravenous infusion administered over a short period of 2-3 hours. The old treatment required 28 days. 


After several weeks of being sick and missing school, 15-year-old Naina waits excitedly with her mother to receive the intravenous infusion at MSF’s kala azar ward. She returned home a few hours later.


Dr Deepak Kumar examines a patient at Sadar Hospital, Vaishali District, Bihar, India.


While MSF handed over its kala azar programme to the Bihar State government in August 2015, it continues to maintain a partial presence in Hajipur’s Sadar Hospital in Vaishali District, focusing on the diagnosis and treatment of HIV-Kala azar coinfected patients. More: /article/msf-hands-over-its-medical-programmes-bih…



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