bhaarat mein kaalaa ajaar

bhaarat mein kaalaa ajaar (visaral leishmaniasis) kaalaa ajaar roga kii vishesh paristhitiyon koo sandarbhit kartaa haye kyonki yeh bhaarat mein maujood haye. kaalaa ajaar bhaarat mein ack pramukh swaasthya samasya haye, jisamen 2012 taka prati varsh anumaanit 1,46,700 nae mamle saamane aae hain. iss bimari mein ack parjivi yakrit, pliha aur asthi majja jaise aantarik angon mein jaane key baad bimari kaa kaaran banata haye. yadi upchaar naa kiya jaae tou bimari kaa parinam lagbhag hamesha mrityu mein hotaa haye. sanketon aur lakshnon mein bukhaar, vajan ghataana, thakan, anaemia aur yakrit aur pliha kii paryaapt soojan shamil hain.
logon koo yeh bimari sandflies key kaatane seey hoti haye, joe swayam parjivi seey sankramit kissy anya vyakti kaa khoon peene seey parjivi bunn jaataa haye. vishva star parr 20 seey adhik alag-alag "leishmania" parjivi hain joe bimari kaa kaaran banate hain aur rait kii makkhi kii 90 prajaatiyan hain joe una parjeeviyon koo failaati hain. bhaaratiya upmahadweep mein, halanki, parjivi kii kewal ack hii samanya prajaati haye, "leishmania donovani" aur rait kii makkhi kii kewal ack prajaati, "flabotomous organtips", joe roga failaati haye. roga kaa roop, parjivi koo khatm karane key liye dawa, aur keat kaatane koo rokane key liye keetnashak kshetra key anusaar bhinn hotey hain, aur bhaarat key liye sifaarishen hain.
vyaktigat laagat key alawa, iss bimari kii prabhaavit samudaayon aur samanya roop seey bhaarat key liye ack badee aarthik laagat haye.
prakaar.
2012 kii ack report mein 2004-8 detta key aadhar parr anuman lagaaya gayaa thaa kii kaalaa ajaar key nae vaarshik mamalon kii sankhya bhaarat mein cumm seey cumm 1,46,000, bangladesh mein 12,000 aur nepal mein 3,000 thee. sankraman leey jaane vaale sabhi logon mein, upmahadweep mein 10 pratishat logon mein kaalaa ajaar haye, 10 pratishat mein pee. key. dee. ell. haye, aur 80 pratishat mein lakshan naheen hain.
kaalaa ajaar.
kaalaa ajaar, jise visaral leishmaniasis bhee kahaa jaataa haye, ack aisee bimari haye jisamen ack parjivi yakrit, pliha (isaliye "visaral") aur asthi majja jaise aantarik angon mein sthanantarit hoe jaataa haye. yadi anupachaarit chhod diyaa jaataa haye, tou lagbhag hamesha mezban kii mrityu hoe jaayegi. sanketon aur lakshnon mein bukhaar, vajan ghataana, thakan, anaemia aur yakrit aur pliha kii paryaapt soojan shamil hain.
kaalaa ajaar vaale logon mein, lakshnon mein bhinnata hoti haye, aur kuchh logon mein asamanya lakshan hoe sakate hain.
lakshanheen kaalaa ajaar.
asymptomatic kaalaa ajaar (jise asymptomatic "leishmania" sankraman bhee kahaa jaataa haye) taba hotaa haye jaba kissy koo sankraman hotaa haye lekin lakshan naheen dikhate hain.
kaalaa ajaar key lakshnon vaale pratyek 1 vyakti key liye, 4-17 logon mein lakshanheen kaalaa ajaar hoe sakata haye. kaalaa ajaar vaale vyakti key nikat sampark mein aaney vaale kissy bhee vyakti key liye lakshanheen kaalaa ajaar kaa khatra adhik hotaa haye. adhikansh loga joe lakshanheen kaalaa ajaar key liye sakaratmak pareekshan karenge, way sankraman koo swabhavik roop seey saaf curr denge. lakshanheen logon key beach 1 varsh key bheetar kaalaa ajaar vikasit hoe jaayega.
post-kaalaa-azaar dermal leishmaniasis.
post-kaalaa-azaar dermal leishmaniasis (pee. key. dee. ell.) visaral leishmaniasis (vee. ell.) kii ack jatilata haye; yeh ack rogi mein ack macular, maculopapular aur nodular raish dwara visheshta haye joe vee. ell. seey thheek hoe gayaa haye aur joe anyatha thheek haye. post kaalaa ajaar" kahey jaane key bavjood, 29 pratishat mamle una logon seey saamane aatey hain jinhen kabhi kaalaa ajaar naheen huaa thaa, aur jinhen pahale ack lakshanheen sankraman thaa.
vector.
duniya key vibhinn sthaanon parr vibhinn sandflies vibhinn "leishmania" parjeeviyon koo prasaarit karati hain joe kaalaa ajaar key vibhinn roopon kaa kaaran banati hain. bhaaratiya upmahadweep mein vishesh sandfly "flabotomous organtips" haye aur yeh "leishmania donovani" koo prasaarit karati haye. bhaarat mein roga koo rokane kaa ack hissa keat key kaatane koo rokna haye.
keat key kaatane koo rokane key liye ack chunauti paaristhitik detta kii kamee aur keat key jeevan key baare mein jaankaari kii kamee haye. paaristhitikiya jaankaari joe yeh bhavishyavani karegi kii sandflies kaba aur kahaan rahati hain, unamen tapman, barish, havaa kii gati, saapeksh aardrata, mitty kii namee, ph aur kull carbonic carbon shamil hain. yadi vaha jaankaari upalabdh hoti, tou yeh adhyayan karna aasaan hotaa kii keat kaba kaatate hain, way jaanvaron yaa manushyon koo kaise kaatate hain, aur way kahaan prajanan karate hain. keat jeevan aur vyavhaar key baare mein jaanane seey dakshata badhegi aur kaalaa ajaar koo rokane key liye saarvajanik swaasthya karyakramon kii laagat cumm hogi.
kaalaa ajaar vaale jilon mein 90 pratishat gharon mein keetnashak upchaarit jaal kaa upayog roga key prasaar koo niyantrit karane kaa ack prabhaavi hissa hoe sakata haye.
iss baat kaa koee saboot naheen haye kii kaalaa ajaar key prasaar key liye janwar ack pramukh chinta kaa vishay hain. maveshiyon, bhainson, murgiyon, jangli choohon aur kutton key parikshanon mein bahut cumm yaa koee sankraman naheen paaya gayaa. kuchh pramaan hain kii bakariyaan sankraman key jalaashay hoe sakati hain.
upchaar.
kaalaa ajaar ack samudayik samasya haye aur upchaar mein vyaktigat aur samudayik bhagidari kii aavashyakta hoti haye. upchaar swaasthya seva karmchaariyon key saath shuru hotaa haye joe bimari vaale logon kii talash karate hain. kleenikon mein lekin kshetra mein bhee pareekshan kiya jaa rhaa haye. pareekshan aur nidan key usee dinn ack clinic mein liposomal amphotericin bee kaa ekal injection pasandida upchaar haye. sub kuchh ack baar mein karane seey loga aasaani seey ilaaj puuraa curr sakenge. upchaar key baad bhee, logon koo kuchh sanyojan chikitsa sahit anuvarti kaarravaai kii aavashyakta hoe sakati haye. kuchh logon koo vaikalpik chikitsa kii aavashyakta hoe sakati haye aur anya davaaen prabhaavi hain.
vee. ell. aur pee. key. dee. ell. key liye upalabdh ekmatra upalabdh maukhik dawa miltefoscin haye. jabaki dawa vee. ell. key alpakaalik upchaar key liye kaam karati haye, pee. key. dee. ell. koo iss dawa key saath 28 dinon seey adhik key lambe upchaar kii aavashyakta hogi. pee. key. dee. ell. key ilaaj key liye monotherapy key roop mein upayog key liye miltefoscin kii sifarish naheen kii jaati haye.
roga kaa unmoolan.
bhaarat mein kaalaa ajaar kaa unmoolan sambhav haye aur aisaa karane key liye anukool paristhitiyaan hain. iss kshetra mein roga paida karane vaale parjivi key liye manushya hii ekmatra jalaashay mezban hain. iss roga key manushya seey manushya mein failane kaa ekmatra tarika iss kshetra mein ack keat, "flabotomous organtips" haye. 2009 taka, yeh bimari kewal bhaarat, bangladesh aur nepal key 109 jilon mein maujood thee. iss bimari kaa nidan karna aasaan haye, yahaan taka kii khet mein aur clinic key baahar bhee. jaba pareekshan kissy rogi kii sthiti key saath pehchaan kartaa haye, tou upalabdh davaaen parjivi koo hataane mein poori tarah seey prabhaavi hoti hain.
iss bimari koo khatm karane kaa vartamaan lakshya 2020 taka 10,000 logon mein isaki darr 1 seey cumm karna haye.
unmoolan ranneeti kaa ack hissa jaldi mamle kaa pataa lagaane aur upchaar key karyakramon key saath-saath dee. dee. tii. key saath upchaarit machhardani dekar ack vector key roop mein sandflies koo cumm karna thaa.
chunauti.
kaalaa ajaar koo samaapt karane mein pramukh chunautiyon mein swaasthya dekhbhal taka pahunch kii kamee, dawa pratirodh key liye yojana banaana, kaalaa ajaar vaccine kii anupasthiti aur sankraman failaane vaale keat koo niyantrit karane mein kathinaaee shamil hain. nidan, upchaar aur teeke key vikas mein pragati mahatvapurna haye aur unmoolan yojana kaa margadarshan curr rahee haye. kaalaa ajaar koo samaapt karane kaa ack karyakram kewal sthaaniya samudaayon key majboot samarthan key saath kaam karega. upchaar key liye aur prasaar koo rokane key liye jitani jaldi hoe sakey mamalon kii pehchaan karane key liye varshon taka saarvajanik swaasthya nigrani aavashyak haye.
parjivi vaale manushya sankraman key jalaashay hain joe roga koo punarjeevit curr sakate hain, bhale hii yeh samaapt hoe gayaa hoe. lakshanheen kaalaa ajaar vaale loga abhee bhee bimari faila sakate hain aur isaliye way loga joe kaalaa ajaar seey thheek prateet hotey hain, lekin joe baad mein pee. key. dee. ell. vikasit karate hain.
unmoolan key liye sambhaavit badey khatare dawa pratirodh aur keetnashak pratirodh hain aur davaaon kaa upayog karane key liye dawa suraksha sunishchit karane key liye pharmacovisilance kii aavashyakta haye.
saarvajanik swaasthya karyakram.
bhaarat kii rashtriya swaasthya neeti, 2002 ney 2010 taka kaalaa ajaar koo samaapt karane kaa lakshya nirdhaarit kiya. bhaarat kii kendra sarkaar ney 2003 mein mamle panjikaran key saath raajyon kaa samarthan karna shuru kiya. 2005 mein bhaarat, nepal aur bangladesh kii sarkaaron ney iss kshetra mein kaalaa ajaar koo samaapt karane mein sahyog karane key liye vishva swaasthya sangathan key saath ack pahal shuru kii.
bhaarat ney lakshya varsh koo 2015 mein badal diyaa. jaba varsh aaya tou anishchitata thee kii lakshya puuraa hoe jaayega. farwari 2015 mein bhaarat, bangladesh aur nepal key swaasthya mantri thyland aur bhootaan key swaasthya mantriyon key saath 2017 taka kaalaa ajaar koo samaapt karane key liye ack naee lakshya tithi nirdhaarit karane key liye shamil hue.
itihas.
bhaarat lambe samay seey kaalaa ajaar key liye dawa vikas mein shamil rhaa haye.
east india company key ack sainya chikitsak villium twinning ney 1835 mein kaalaa ajaar kaa ack aadhunik chikitsa vivaran likhaa.
1903 mein villium boog leashman, ack british senaa key chikitsa adhikaari, ney kalkutta key paas dumm dumm seey parjivi kii pehchaan kii joe kaalaa ajaar kaa kaaran banate hain. unaki report sahee thee, aur vaigyaanikon ney parjivi "leishmania" koo unakaa naam diyaa aur bimari key paschimi naam, leishmaniasis koo diyaa.
bangali chikitsak aur vaigyaanik upendranath brahmachaari ney 1946 mein apani mrityu taka kaalaa-ajaar key baare mein ilaaj, shodh aur prakaashan kiya.
bhaarat kaa rashtriya maleria unmoolan karyakram 1953 aur 1964 key beach maleria koo rokane key liye keetnashak key roop mein dee. dee. tii. kaa upayog curr rhaa thaa. dee. dee. tii. atyadhik prabhaavi haye jise manushyon aur paryaavaran key liye bhee vishaakt honey key kaaran pratibandhit curr diyaa gayaa thaa. jaba bhaarat dee. dee. tii. kaa upayog curr rhaa thaa, taba maleria koo cumm karane key usa prayaas ney bhee sandflies koo maar daala aur kaalaa ajaar koo roque diyaa. 1964 key baad aur dee. dee. tii. key upayog key bund honey key baad, kaalaa ajaar laut aaya, lekin doctors ney isaki anupasthiti key baad bimari koo pahachaana naheen.
lagbhag 1960-1975 seey, upmahadweep mein kaalaa ajaar kaa koee record naheen thaa. 1978 mein nepal key logon ney iss bimari kii soochana dee. 1980 seey yeh bimari kaee logon mein fail gaee.
vishesh aabaadi.
roga key ilaaj mein ack mahatvapurna samasya honey key liye quackery kaafee aam haye. sarkaar aadhikarik kleenikon koo sulabh banaana chaahati haye, lekin kaee loga binaa licenses vaale chikitsa vyavsaayiyon seey sevaaen lete hain.
mahilaaon kii tulanaa mein purushon koo kaalaa ajaar milane kii adhik sambhavana hoti haye.
kaalaa ajaar vaale bachchon mein vayaskon key samaan lakshan hotey hain. miltefoscin vayaskon key roop mein bachchon mein upchaar key roop mein prabhaavi aur achchi tarah seey sahan kiya jaataa haye aur yeh pahali pankti kaa upchaar hoe sakata haye. kaalaa ajaar key 90 pratishat mamle bihaar mein hain, aur vahaan key bachchon parr 50 pratishat viklang jeevan key varshon key nuksan kaa bojh haye.
aich. aaee. vee. positive logon mein kaalaa ajaar key punah sankraman kaa adhik khatra hotaa haye.

