Incidence and Control of Kala-Azar in the Eastern Districts of United Provinces

Kala-azar as a distinct clinical entity has been recognized in this country for about a century. A number of epidemics occurred in Bengal, and though it was in early stages confused with malaria, failure to respond to specific treatment led to the establishment of its separate entity. This was confirmed in 1903 by the discovery of Leishman-Donovan bodies? the causative organism, by W. B. Leishman in the spleen of a soldier who died in England from kala-azar which he had contracted at Dum Dum and by C. Donovan in Madras in material from spleen puncture carried out on patients believed to be suffering from malarial cachexia (Scott, 1942). It invaded Assam in 1875, and swept up the Brahmaputra valley in three different epidemics between this date and 1917 (Napier, 1946). In Bihar, there was an epidemic of kala-azar in 1939-41 and the province suffered heavily from its ravages (Sen Gupta, 1947). It now seems to have slowly infiltrated the eastern districts of United Provinces during the last 25 years. According to Napier (loc. cit.) the disease is endemic in this province as far west as Lucknow, where the infiltration gradually tails off, its westerly extension being checked by the dry areas. Sporadic cases have even been reported from the Punjab, Delhi, Jaipur and Mussoorie (Heiiig and Sachdev, 1947; Amir Chand et al, 1948). The heavily infected districts in the United Provinces, so far known at present, are Gorakhpur, Deoria, Basti and Banaras. In Baharas City, the Municipal Board opened a kala-azar dispensary in the year 1932-33. In Gorakhpur district, first survey of kala-azar was done in 1938. Two rural development travelling dispensaries in this district and one in the district of Banaras at Sakaldiha were opened in 1942 for the heavily infected areas. In 1944, some survey work was done in Basti district as well. With the increasing movement of labour and