Regional Strategic Framework for elimination of kala-azar from the South-East Asia Region (2011-2015)

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The preparatory phase for the elimination of kala-azar from South-East Asia is near completion and has pointed the way forward. The emphasis is now on the attack phase which will focus on the endemic villages and the primary health care units. This will include actively finding kala-azar cases and performing rapid point-of-care diagnosis and treatment with a single dose of liposomal amphotericin B at the primary health care unit. This will be the most effective way to rapidly reduce the kala-azar burden, reduce transmission and reduce the duration of hospital stay. Diagnosis and complete treatment on the same day using liposomal amphotericin B will be easier to manage by the primary health care system, ensure 100% treatment compliance and will be the best option for the patients. Combination therapies involving miltefosine, paromomycin, and liposomal amphotericin B should be used following elimination and as alternative treatments. This approach will be further supported by scaling up providing information, communication and education about kala-azar in the endemic villages to mobilize strong community support for elimination. Finally, sandfly vector control will be implemented using integrated vector control management and the recently developed monitoring and evaluation toolkit to improve the performance of existing vector control strategies. This multiple approach strategy will have a major impact on reaching the elimination target of one case in 10 000 by 2015 in South-East Asia.

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