Evaluation of the outcome of Kala-Azar Control Program in Iraq

Abstract

Visceral leishmaniasis has been recognized as an important public health problem in Iraq for the last 50 years, particularly in the southern governorates owing to its considerable impact on morbidity and its potential to spread in outbreaks and epidemics which impose a heavy burden on the national health services. This study was conducted to evaluate the effectiveness of the national control measures in reducing the number of Kala-azar cases in Al-Diwaniyah governorate (which is a known endemic focus in Iraq), for the years 2007 and 2008. The results of this study at the district level for the years 2007 and 2008 regarding the number of Kala-azar cases and application of control measures revealed that the Kala-azar incidence rates in Al-Di- waniyah governorate for the years 2007and 2008 were 1.4 and 0.8 per 1000 in children less than five years, respectively. The number of Kala-azar cases recorded for the year 2007 was 399 cases, which constituted 12.2% of the total cases in Iraq, this included 216 cases (54.1%) from areas where active control measures (spraying, rodents control campaign and euthanization of jackals and stray dogs) were not applied, and 183 cases (45.9%) from areas were such measures were applied. In the year 2007, the differences in the number of cases between areas without and areas with control measures were highly obvious in all districts. In the year 2008, the differences in the number of cases between areas without and areas with control measures were highly obvious in all districts with the exception of Al-Hamza district. Comparison of the number of cases recorded during the year 2007 in areas before active intervention with the number of cases recorded in the same ar eas during the year 2008, after this intervention revealed that these active control measures were 58.8 % effective in reduction of Kala-azar cases.