Kala-Azar is found endemic in all of the following areas EXCEPT
Correct Answer: Assam
Description: (D) Assam [?]Leishmaniasis are a group of protozoal diseases caused by parasites of the genus Leishmania, and transmitted to man by the bite of female phlebotomine sandfly.oResponsible 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 (1). The visceral type of disease, kala-azar, is still an important disease in India.oLeishmaniasis is endemic in many countries in tropical and subtropical regions, including Africa, Central and South Americas, Asia and the Mediterranean region.oKala-azar is endemic in 52 districts in Bihar, Jharkhand, West Bengal and Uttar Pradesh.oAbout 130 million population is at risk of the disease.oThe present situation is shown in Table 1. While both cutaneous (ZCL and ACL) and visceral (VL) disease occur in India, kala-azar is by far the most important leishmaniasis in India.STATE WISE KALA-AZAR CASES & DEATHS IN INDIAState2013CasesDeaths*. Bihar10,73017*. West Bengal5950*. Uttar Pradesh111*. Jharkhand2,5150*. Delhi60*. Assam40India3,86920 [?]Status of Kala-azar in IndiaoKala-azar is endemic in 52 districts (31 in Bihar, 4 in Jharkhand, 11 in West Bengal & 6 in Utter Pradesh.oDuring the 2013 year, 13,869 cases and 20 deaths have been reported.o165 million people are estimated to be at riskoEstimated number of cases much higheroNo accurate data on burden of PKDL.oAltitude:-Kala-azar is mostly confined to the plains; it does not occur in altitudes over 2000 feet (600 metres).oSeason:-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.oClimate 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.oRural Areas:-The disease is generally confined to rural areas, where conditions for the breeding of sandflies readily exist compared to urban areas.oVectors:-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.-Their habits are primarily nocturnal.-Only the females bite.
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