Which state is more prevalent for Kala azar

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Kala azar visceral leishmaniasis most prevalent state India 2024

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Kala-Azar (Visceral Leishmaniasis) - Most Prevalent State in India

Bihar is by far the most prevalent state for Kala-azar in India. The data is unambiguous across all sources:

(from Park's Textbook of Preventive & Social Medicine)

State	2016 Cases	2017 Cases	2018 Cases
Bihar	4,773	4,127	3,423
Jharkhand	1,185	1,358	752
West Bengal	177	156	95
Uttar Pradesh	107	115	110
India Total	6,245	5,758	4,380

Bihar alone accounts for roughly 76-78% of all Kala-azar cases in India each year.

Endemic districts: Kala-azar is endemic in 54 districts across 4 states. Bihar alone has 33 out of its 38 districts affected - the widest district-level spread of any state. Compare this to Jharkhand (4/24), West Bengal (11/23), and Uttar Pradesh (6/75).
Why Bihar? Bihar is a poor, rural state with conditions that favor sandfly breeding - poor housing, mud walls, high humidity along the Gangetic plain, and inadequate vector control. Bihar also has high rates of Leishmania-HIV co-infection.
India's global burden: India accounts for approximately 18% of the world's Kala-azar cases (2020 data, WHO), with the disease being fatal in over 95% of untreated cases.
Good news: India has made major progress - from 9,200+ cases in 2014 down to under 500 cases in 2023, putting the country close to the WHO elimination threshold of <1 case per 10,000 population.
Sporadic cases are also reported from Assam, Gujarat, Himachal Pradesh, Jammu & Kashmir, Kerala, Sikkim, and Tamil Nadu, but these are not considered endemic zones.

To summarize: Bihar is the most prevalent state for Kala-azar in India, historically contributing ~80% of the national burden.

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