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jan 25 2012- dr. matlashewski.docx

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Microbiology and Immun (Sci)
MIMM 413

Infectious Disease Burden Worldwide This is on a DALY basis Leishmaniasis is very high on the list on a DALY basis Looking at South East Asia it is the highest of any of the other infectious diseases It is an infectious disease burden specific to that part of the world Geographic Regions They are clustered in one corner that borders India Nepal and Bangladesh high levels of Leishmanaisis So it is not present throughout these countries it is just at the border 60 of all the visceral Leishmanaisis cases in the world occurs there Another area with 40 of the rest is in Sudan But each region has its own politics its own transmission mode the societies are different etc So even though one method may work here it may not be effective in Sudan Opportunities in the Indian Subcontinent Slide missing re typed Elimination here is reducing it to a level of 110000 Now it is at 2010000 Epidemiological features in the Indian subcontinent 1 Human beings the only reservoir 2 Only one vector species which is amenable to control 3 Geographical distribution is limited and highly clustered Recent developments New drugs Miltefosine AmBisome and Paromomycin Rapid diagnostic simple and rapid rk39 Dipstick test for VL Leishmaniasis implementation research initiatives in the Indian subcontinent 1 One problem with these diseases is that people stay in the villages and do not seek treatment even though they are very sick If they have the disease and do not seek treatment they are able to transmit the disease to family members and other people in the village 2 Blocking the sandfly from biting blocks the disease at that level 3 In the past people had to be treated for 20 days in a row Treatment was only available at larger hospitals in large cities not everyone had access to this Now the treatments are being moved closer to the community and away from the cities as the infection is not in the cities Training of Village ASHAs to identify potential VL cases All of the villages have one woman that looks after the health of women Her job is to look after pregnant women and make sure that they do not deliver in villages but in local primary health care centers small health care outpost with about 6 beds and 2 doctors
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