Sample survey for indigenous cases of kala-azar in Assam by rk39 dipstick test.

In 1950s the Government of India under National Malaria Eradication Programme (NMEP) now National Vector Borne Disease Control Programme, launched massive insecticidal spraying with DDT for malaria vector control and kala-azar came to a halt in Assam as a collateral benefit of malaria eradication programme. As a result, there were no further reports of kala-azar from the northeastern region except some sporadic cases. We report here the re-emergence of kala-azar in Assam in outbreak form. An outbreak of fever in Chapaidang village, Chandrapur area of Kamrup Metro District in Assam was investigated during February 21 to 26, 2008. Chapaidang village with a population of about 800 is located on a foothill and is 20 km from Guwahati city. The local medical practitioner from the area recorded the presence of many febrile cases of longer duration presented with splenomegaly, anaemia, weakness and loss of weight not responding to antimalarials therapy and requested epidemiological investigation. Accordingly, we investigated the cause of febrile illness. During houseto-house visit all suspected subjects were enrolled after taking informed consent. Information like duration of fever, visit to other areas, other known ailments, their professions and recent treatment taken were recorded on a pre-designed proforma. Demographic data and previous record of Primary Health Centre revealed that the area was endemic for malaria. Looking into the patients’ clinical details, topography of the place and the key informants (doctors) description of cases, a primary suspicion of kala-azar was made. Ten randomly selected houses having congenial environment for vector (Phlebotomus argentipes) propagation were chosen for sand fly collection from the area.