Simple new test for kala azar

Medicins Sans Frontieres, the international humanitarian and medical relief agency, has called for the adoption of a simple kit to screen for kala azar, one of the world’s neglected diseases.

The easy-to-use Opti Leish diagnostic kit is already in use in some clinics run by MSF in northern Kenya.

Using the kit, a kala azar test can be done in much the same way a simple malaria screening is done using a drop of the patient’s blood.

Kala azar (visceral leishmaniasis) is endemic in parts of Kenya and Uganda.

It is transmitted by the sand fly and kills about 50,000 people each year globally out of 500,000 affected.

Its symptoms are weight loss, swelling of the spleen and liver, and anaemia. If left untreated, it can have a fatality rate as high as 100 per cent within two years.

“Anybody who can do a finger prick, who knows how to keep time and how to count drops can use this test,” said an MSF doctor, Dagemlidet Worku, on the organisation’s website. “The results come through in 20 to 25 minutes and are around 97 per cent accurate in terms of sensitivity and specificity.”

According to MSF, more widespread use of the simple test will expedite the fight against kala azar, since the current recommended screening methods, which require electricity, are not widely available in far-flung health clinics.

Another hurdle that needs to be overcome, MSF says, is the challenge of providing effective treatments to those diagnosed with the disease. Only a handful of drugs exist to treat kala azar.

The most common treatment used today, a drug known as sodium stibogluconate (SSG), was developed in the 1930s.

Its use is long and painful, consisting of intra-muscular injections every day for 30 days. It is also expensive, costing at least $100 in private pharmacies.

The second line treatment, which is used when SSG fails, is called ambisome.

It is much more favourable than SSG, being a seven-day treatment course that is administered as an infusion.

According to MSF, ambisome is 98 per cent effective in the treatment of kala azar.

Observed Dr Worku about current treatements: “It’s a shorter treatment, which is more effective and less toxic. If the pharmaceutical industry were researching and developing alternative treatments for kala azar obviously we would prefer to treat all our patients with Ambisome. But there are not many new drugs coming onto the market so we have to save the best treatment for difficult cases, because if people develop resistance to Ambisome then we’re really left with no options.”