30-Dec-2020: Dr. Harsh Vardhan reviews status of Kala Azar in Four States of Uttar Pradesh, Bihar, Jharkhand and West Bengal
Dr. Harsh Vardhan, Union Minister of Health and Family Welfare today chaired an event to review the status of the disease Kala-Azar in the four states of Uttar Pradesh, Bihar, Jharkhand and West Bengal.
Shri Mangal Pandey, Minister of Health, Bihar, Ms. Chandrima Bhattacharya, Minister of State for Health and Family Welfare, West Bengal, Shri Jai Pratap Singh, Minister of Medical and Health, Family Welfare, Mother and Child Welfare, Uttar Pradesh and Shri Banna Gupta, Health, Medical Education & Family Welfare, Jharkhand were also present in the event.
The Union Health Minister started by reminding the audience that the Government of India is strongly committed to the elimination of Kala Azar. He stated “Kala Azar is the 2nd largest parasitic killer in the world after Malaria and results in a 95% fatality rate if the patients are not treated. Additionally, up to 20% of the patients who are correctly treated and cured, develop a skin condition called Post-Kala-Azar Dermal Leishmaniasis (PKDL) which surfaces within months to years after treatment. These patients can contain large amounts of parasites in their skin lesions, making them an important source of transmission.” He was apprised that there are 54 districts in four states namely Bihar, Jharkhand, Uttar Pradesh, and West Bengal that are currently affected by Kala-azar with sporadic cases in other states like Assam, HP, J&K, Kerala, Sikkim, and Uttarakhand.
Speaking on the gains made in elimination of Kala Azar, he noted:
- As of 30th November 2020, only 12 blocks in Jharkhand and 4 blocks in Bihar have reported more than 1 case per 10,000 population.
- Bihar which has traditionally had a large burden of Kala-azar has achieved elimination target in almost all except 4 blocks located in districts of Siwan and Saran (out of 458 blocks).
- Jharkhand too has made significant progress both in reduction of Kala-azar and PKDL cases, as well as in number of blocks reporting more than 1 case per 10,000 population.
- Uttar Pradesh and West Bengal have achieved their elimination target and needs to be more vigilant and diligent to consolidate and sustain their gains; they will earn the Elimination Certificate at the end of 3 years.
Appealing to all the District Magistrates and their officers at the district and block/level that are still reporting more than 1 case per 10,000 population to take some time out of their schedule for a regular review of Kala-azar and to help the district teams in overcoming the issues coming in the way of elimination target, Dr. Harsh Vardhan said, “A risk based stratified approach needs to be formulated with clear activities and responsibilities that come with measurable monitoring indicators. Kala Azar disproportionately impacts the people at lower socio-economic strata of society whose houses are not sprayed often. In addition, they are unable to apply for pucca houses since they don’t own land.”
In this respect, he underlined the importance of the following activities to target the elimination of the disease:
- Development of a plan for the “unreached poorest” or underprivileged sections in endemic areas.
- Leveraging of Kala-azar elimination programme within POSHAN Abhiyaan for maximum benefit at community level.
- Exploration of the opportunity of providing improved housing under the flagship program of the Prime Minister Awaas Yojana-Gramin (PMAY-G). (The Minister added that Jharkhand has made good progress on this front).
- Exploration of the opportunity of providing improved housing under State Schemes, as has been done by Jharkhand under Birsa Munda Awaas Yojana and Bhimrao Ambedkar Awaas Yojana.
- Involvement of Rural Health Practitioners (RHPs) who are often used as the first point-of-care in referral, surveillance, and IEC.
- Co-ordination with the rural development department and engage with Panchayati Raj functionaries for awareness, community engagement, environment management and social empowerment.
- Focusing on IEC messages on prolonged fever, associated symptoms and free access to diagnosis and treatment, proper use of ITN/LLINs, and compensations/incentives.
Dr. Harsh Vardhan explored possible solutions in this regard like sensitization of the population, proper training of human resource, quick completion of Prime Minister’s dream of ‘Housing for All’ by 2022, strengthening adverse drug reaction reporting system, both for Kala-azar and PKDL with special focus on PKDL cases with eye complications, institutional management of Kala Azar/HIV cases at the district level, etc.
4-Nov-2020: CSIR-CDRI Scientist, Dr Susanta Kar, honoured with “Prof. A N Bhaduri Memorial Lecture Award-2020" by the Society of Biological Chemists (India)
To recognize the significant contributions towards defining the survival tactics of Leishmania donovani, Society of Biological Chemists (India) has chosen Dr Susanta Kar, Senior Scientist, Molecular Parasitology and Immunology, CSIR-CDRI, Lucknow for this year's Prof. A N Bhaduri Memorial Lecture Award.
Leishmania Donovani is a protozoan parasite that infects macrophages and is a causative agent of visceral leishmaniasis (Kala Azar), a lethal infectious disease affecting millions worldwide. DR. Susanta Kar’s research group studied the interaction of Leishmania with immune cells like macrophages, dendritic cells and T cells and the fate of these interactions on modulation of various intracellular signaling cascades that ultimately affect immune response/infection progression.
Society of Biological Chemists (India) has instituted many awards, in order to recognize the meritorious and significant contributions made by the researchers/scientists on the development of biological sciences in the country, The Society of Biological Chemists (India) or SBC(I) was founded in 1930, with its Head Quarters at Indian Institute of Science, Bengaluru. This prestigious society was registered under the Societies Act in the then Princely State of Mysore.
The award is conferred in every two years. Recipient of the award should be below 50 years of age. The Award is given for Biological Chemistry and Allied sciences, preferably related to parasitic infections.
21-Aug-2020: Oral nanomedicine may bring relief for Kala-Azar & other neglected diseases
Patients affected by Kala- Azar, scientifically called Visceral leishmaniasis (VL), one of the most neglected tropical diseases may soon find relief in an oral nanomedicine from India. The oral therapeutics could help in the control and elimination of VL, around 95 % of which is reported from Bangladesh, Brazil, China, Ethiopia, India, Kenya, Nepal, Somalia, South Sudan, and Sudan.
Scientists from the Institute of Nano Science & Technology (INST), Mohali, an autonomous institute of the Department of Science & Technology, Govt. of India, have developed an oral nanomedicine with the help of surface-modified solid lipid nanoparticles based combinational cargo system for combating visceral leishmaniasis. The findings of their study supported by the DST-SERB Early Career Research Award have been recently published in the journals ‘Scientific Reports’ and ‘Materials Science & Engineering C’.
According to the INST team, till-date there is no study reported where a combination of two anti-leishmanial drugs has been delivered through nanomodification as a potential therapeutic strategy against visceral leishmaniasis. This work suggests the superiority of as-prepared modified formulation (m-DDSLNs) surface modified with 2-hydroxypropyl-β-cyclodextrin (HPCD) as a promising approach towards the oral delivery of anti-leishmanial drugs.
In this study by INST team led by Dr. Shyam Lal M anti-leishmanial drugs Amphotericin B (AmB) & Paromomycin (PM) were encapsulated in solid lipid nanoparticles and further modified with 2-hydroxypropyl-β-cyclodextrin (HPCD). The scientists explored the oral therapeutic potential of the formulation in the treatment of visceral leishmaniasis. They employed an emulsion solvent evaporation method to prepare HPCD modified dual drug-loaded solid lipid nanoparticles (m-DDSLNs). The nanoparticle-based combinatorial drug delivery system developed by them enhanced the efficacy of the formulation in both in vitro and in vivo models by reducing intracellular amastigote growth in L. donovani-infected macrophages and hepatic parasite burden in L. donovani-infected BALB/c mice model, respectively without causing any significant toxic side effects.
According to the INST team, the solid lipid nanoparticles (SLNs) can help enhance the oral uptake of the therapeutic agent by retaining a solubilized state of the drug in the Gastrointestinal Tract and favors the formation of mixed micelles (a special case of solubilization) by inducing the secretion of bile salts and phospholipids. Further, 2-hydroxypropyl-β-cyclodextrin (HPCD) are cyclic oligosaccharides that are known to be molecular hosts which can selectively include water-insoluble guest molecules within their hydrophobic cavity through non-covalent interactions.
This study by INST team may lead to product and process patent enhancing the role of our country for developing innovative therapy against neglected diseases. The usage of lower therapeutic dose of the purified drugs through nanomodifications will be boon in reducing toxicity, which has been a major hindrance in the existing conventional treatment when administered orally.
24-Jun-2020: New biomolecules to fight drug resistance in Kala- azar
Leishmaniasis is a neglected tropical disease affecting almost 100 countries including India. It is caused by a parasite called Leishmania, which is transmitted through the bite of sand flies.
There are three main forms of leishmaniasis – visceral, which affects multiple organs and is the most serious form of the disease, cutaneous, which causes skin sores and is the most common form); and mucocutaneous, which causes skin and mucosal lesion).
Visceral leishmaniasis, which is commonly known as Kala-azar in India, is fatal in over 95% of the cases, if left untreated. The only drug available against leishmaniasis, miltefosine, is rapidly losing its effectiveness because of emerging resistance to this drug due to a decrease in its accumulation inside the parasite, which is necessary for the drug to kill the parasite.
Specific types of protein molecules, called transporter proteins, play a major role in carrying miltefosine into and out of the parasite’s body, which comprises a single cell. A protein called ‘P4ATPase-CDC50’, is responsible for intake of the drug by the parasite, and another protein, called ‘P-glycoprotein’, is responsible for throwing this drug out from within the parasite’s body.
A decrease in the activity of the former protein, and an increase in the activity of the latter results in less amounts of miltefosine being accumulated inside the parasite’s body, thus causing it to become resistant to the drug.
A team of researchers at the Department of Biotechnology’s National Centre for Cell Science (DBT-NCCS) in Pune led by Dr. Shailza Singh has been exploring ways to tackle miltefosine resistance. The researchers worked with one of the species of Leishmania that causes infection, called Leishmania major. They tried to manipulate these transporter proteins in the species in a manner that would result in increased uptake of the drug and decrease in its being thrown out of the parasite’s body.
Scientists need to be extremely careful while seeking to manipulate the transport proteins. They exist across a diverse range of organisms from bacteria to mammals, including humans and any mishandling could cause more harm than be of use. Consequently, though various researchers have been working over the past two decades to combat drug resistance, their activities were limited to laboratory studies.
Dr. Singh’s research group used computational methods to design small molecules, called peptides, that could very specifically interact with the transporter proteins of L. major alone, and not interfere with human proteins in any way. The peptides were designed to modulate the transporter proteins “allosterically”, i.e. by interacting with the protein molecule at a location other than the specific location where miltefosine binds to it.
This group is the first to have shown allosteric modulation of transporter proteins of Leishmania using computationally-designed synthetic peptides, and their findings were reported in the ‘Biochemical Journal’. These promising research outcomes indicate that this approach could prove useful in the long run to develop novel therapeutics against drug-resistant Leishmania parasites.