| 26th October 2016 06:32 PM | |
| shikha | Re: NVBDCP Guidelines On Diagnosis And Treatment Of Kala-Azar Don’t worry I will tell you National Vector Borne Disease Control Programme, Guidelines On Diagnosis And Treatment Of Kala-Azar. Diagnosis Clinical: A case of fever of more than 2 weeks duration not responding to antimalarials and antibiotics. Clinical laboratory findings may include anaemia, progressive leucopenia thrombocytopenia and hypergammaglobulinemia Laboratory: Serology tests: Variety of tests are available for diagnosis of Kala-azar. The most commonly used tests based on relative sensitivity; specificity and operationally feasibility include Direct Agglutination Test (DAT), rk39 dipstick and ELISA. Aldehyde Test is commonly used but it is a non-specific test. IgM detecting tests are under development and not available for field use. Parasite demonstration in bone marrow/spleen/lymphnode aspiration or in culture medium is the confirmatory diagnosis. Though spleen aspiration has the highest sensitivity and specificity (considered gold standard) but a skilled professional with appropriate precaustions can perform it only at a good hospital facility. Differential Diagnosis: Typhoid Miliary tuberculosis Malaria Brucellosis Amoebic liver abscess Infectious mononucleosis Lymphoma, Leukemia Tropical splenomegaly Portal hypertension Treatment Kala-azar Drugs available in India Sodium Stibogluconate (indigenous manufacture, registered for use & sale) Pentamidine Isethionate: (imported, registered for use) Amphotericin B: (indigenous manufacture, registered for use and sale) Liposomal Amphotericin B: (indigenous manufacture & import, registered for use and sale) Miltefosine (imported/ registered for use & sale) Drug Policy under Kala-azar Elimination Programme as per recommendations of Expert Committee (2000) – (This drug policy is under review) First Line Drugs A. Short Term Areas with SSG sensitivity >90% SSG IM/IV 20mg/kg/day X 30 days Areas with SSG sensitivity <90% Amphotericin B 1mg/kg b.w. IV infusion daily or alternate day for 15-20 infusions. Dose can be increased in patients with incomplete response with 30 injections B. Long Term Areas with high level of SSG resistance (>20%) Miltefosine 100 mg daily x 4 weeks (after phase III studies completed with proven safety & efficacy) Areas with SSG sensitivity >80% SSG IM/IV 20mg/kg/day X 30 days Miltefosine 100 mg daily x 4 weeks (after phase III studies completed with proven safety & efficacy) Second Line Drugs A. SSG Failures Amphotericin B 1mg/kg b.w. IV infusion daily or alternate day for 15-20 infusions. Dose can be increased in patients with incomplete response with 30 injections B. SSG and Miltefosine Failures Liposomal Amphotericin B (when final results are available with proven efficacy and safety) Treatment of PKDL SSG in usual dosages for KA could be given up to 120 days Repeated 3-4 courses of Amphotericin B can be given in patients failing SSG treatment Address:- National Vector Borne Disease Control Programme 22, SHAM NATH MARG, DELHI - 110054 Phone:- 91–011–23967745, 23967780 |
| 26th October 2016 05:14 PM | |
| Unregistered | NVBDCP Guidelines On Diagnosis And Treatment Of Kala-Azar Can you please suggest me Guidelines On Diagnosis And Treatment Of Kala-Azar fixed by National Vector Borne Disease Control Programme? |
