Eishmaniasis —a growing health hazard for the poor

LAHORE

University of Health Sciences (UHS) and Pak One Health Alliance (POHA) have joined hands to build the capacity of health managers to deal with eishmaniasis, commonly called Kala-Azar, a vector-borne infectious skin disease which has been found as a growing health threat affecting poor communities in the country.

According to a press release, the two organisations will hold a series of orientation and planning sessions for district health managers with regards to the disease.

POHA CEO Dr SM Mursalin said that in Pakistan there was also an urgent need to build corresponding capacities, including skills, services, equipment and drug supplies), to improve detection and response to vector-borne diseases.

Sharing the data, he said that in 2015, Chakwal district was reported to have highest cases of leishmaniasis, 2825 cases. It was followed by Lahore, 397 cases, Khushab, 396 cases, Mianwali, 387 cases, Jhelum, 272 cases and  Multan, 186 cases.

Leishmaniasis, one of the world’s oldest recorded diseases dating back to the 7th century BC, is an entirely treatable parasitic disease spread by female sandflies. According to WHO, there are around 1.6 million new cases each year across 98 countries. Over 40,000 people die of the disease every year, making it the second largest parasitic killer in the world after malaria.

The internationally-funded project is based on the findings of a research carried out by Connecting Organisations for Regional Disease Surveillance (CORDS) in 2015 in Albania, Jordan and Pakistan. According to that research, there are an estimated 50,000 new cases of cutaneous leishmaniasis (commonly known as oriental sore or Delhi boil), the predominant form of leishmaniasis in Pakistan each year.

It is an emerging disease, initially prevalent in refugee communities from Afghanistan, which has also become established in host communities in Balochistan and elsewhere in north-west Pakistan.

The research pointed out that key problem in Pakistan is a lack of access to low-cost quality-assured drugs to treat the condition, particularly in the deprived communities. This has resulted in a market for counterfeit and smuggled drugs of dubious quality, which can have harmful impacts on those being treated. A major barrier to the treatment of leishmaniases is limited budget and resource allocation to communities in the areas where it is prevalent. 

In this regard, UHS Registrar Dr Asad Zaheer, who is also the focal person of the university in this project, said apart from the physical effects, the disease also causes psychological and social stigma from the ulcers and scarring of cutaneous leishmaniasis (CL), which can lead to exclusion from society due to the mistaken belief that the disease is directly contagious

“At a time when diseases such as dengue, Ebola, malaria and influenza have created worldwide awareness of the devastating impact that infectious diseases can have on the communities ill-equipped to deal with outbreaks, leishmaniasis is still very much a growing, but neglected disease”, he added.

Dr Asad said coordinated efforts were needed to raise awareness and interest, as a critical step in addressing the major gaps identified in the treatment and prevention of this and similar vector-borne diseases.

He said UHS role would be facilitative in this project as it would act as a bridge between POHA and the government.