103 Proc. of the Third Intl. Conf. on Advances in Applied Science and Environmental Engineering - ASEE 2015 Copyright © Institute of Research Engineers and Doctors, USA .All rights reserved. ISBN: 978-1-63248-055-2 doi: 10.15224/ 978-1-63248-055-2-73 APPLICATION OF TECHNOLOGIES FOR DIAGNOSIS, TREATMENT, PREVENTION AND CONTROL OF MALARIA, KALA-AZAR AND FILAIA IN ENDEMIC AREAS OF BANGLADESH Hamida Khanum*, Jainal Abedin and Moazzem Hossain Parasitology Branch, Department of Zoology, University of Dhaka, Dhaka 1000, Bangladesh. * Corresponding Author Cell phone 01712-039756 Abstract :The present study was carried out in 13 Upazillas of 13 endemic districts for Malaria and 15 upozillas of 3 endemic districts for kala-azar in Bangladesh. to assess the current application of techniques for Diagnosis, Treatment, Prevention for malaria and kala-azar by the professionals For Malaria, 300 professionals were interviewed of Upazilla Thana Complexes, they apply Examination of peripheral blood film (40.8%) and Rapid Diagnostic test (38.50%) for diagnosis of Malaria and also tests CBC and MP in small range. About 85% professionals use Quinine as an appropriate drug for treating Malaria, drugs like Chloroquinine, Pyremethamine, Artemisinin and Malaone are also in use. For Kala-azar, out of 205 professionals interviewed, about 80% practice rK39 dipstick test for diagnosis of Kala-azar while, DAT, AT, Bone marrow examination and Spleen puncture are rare. About 73.3% professionals use SAG, 85.7% Miltefosine and 62.9% AmphotericinB as appropriate drug for Kala-azar. The filarial cases have been decreasing for taking some preventive steps on filariasis elimination programs. the reasons for long time continuing filariasis due to lack of some important things. Regarding the site of filaria, in most (31.2%) of the cases the right leg-sided filaria. The cases with the more severe grades of lymphoedema complained of physical problems, such as difficulty in standing and/or walking and discomfort because of the heaviness of the affected limb(s). Professionals believe in use of mosquito nets, awareness campaign, insecticide spray, early detection and treatment of kala-azar. and malaria.. These modern technologies are widely used world-wide and Bangladesh for diagnosis, treatment and prevention of malaria and kala-azar, which are safe, have less side- effect and reliable. So, Bangladesh is not behind from the advances in world. Key words: Diagnosis, treatment, kala-azar, malaria and filaria . Introduction Considerable progress has been made towards three key objectives in tropical infectious diseases in recent years, new approaches to overall clinical management. Inadequate vector control; poor nutrition, sanitation, and drinking water; civil war; and bare bones health budgets continue to present obstacles to preventing and controlling epidemics. Early scientific results include progress in chemotherapy for Malaria, Kala-azar and filaria; in the developing the fundamental knowledge required to develop a vaccine against malaria; and in simple and accurate diagnostic field tests for filaria, malaria and kala-azar. In addition, institution strengthening and training support, awarded exclusively to institutions and scientists of developing endemic countries, has increased rapidly. Over 1 billion people are infected with one or more of the 14 Neglected Tropical Diseases (NTD) defined by WHO are most common and living on less than $2 a day Those affected are often marginalized and forgotten by Government, left to suffer in silence. NTD are diverse but all cause severe disability or death, bring a major economic burden on endemic countries. NTDs are also known as “poverty- related” or “tropical” diseases, are sometimes fatal and inflict severe and permanent disabilities and deformities on almost 1 billion people around the world, especially among the poorest populations in developing countries [1,2]. The neglected diseases impose an enormous economic burden on affected communities due to lost productivity and other issues. While there are some drugs and vaccines for neglected diseases, these interventions do not always reach those who need them - even when the drugs and vaccines are donated. Drug resistance is most commonly seen in P. falciparum. Resistance to chloroquine is most prevalent, while resistances to most other antimalarials like pyrimethamine, quinine, mefloquine, artemesin and quinoline compounds have also been reported. These developments further justify the cause and urgency for formulating an effective vaccine against malaria. The vaccine fulfilling this extreme requirement is the type 2 vaccine. This extreme approach to Malaria Vaccine- Development does not take into account specifically populations affected by malaria that fall between these extremes, such as individuals in endemic regions at high risk of P. vivax infections [3,4]. Malaria is one of the major public health problem in Bangladesh. Out of 64 districts, malaria is highly endemic in 13 districts and 10.9 million people are at risk of malaria. Three hill tract districts (Banderban, Khagrachori and Rangamati) and Cox’s Bazar districts report more than 80% of the malaria cases and deaths every year. In Bangladesh, Both falciparum and vivax malaria are prevalent in the country of which the number of falciparum cases are 75% of the total cases in recent years due to increasing drug resistance. The first line drug Chloroquinine has been replaces by Artemisinin based Combination therapy. (ACT) for treatment of falciparum malaria cases in 2004. Anopheles dirus, An. minimus, and An. phillipensis are the principal vectors and all are susceptible to malathion and synthetic pyrethroid. Promotion and use of ITNs/LLINs, selective IRS for containment of outbreaks and intensive IEC for increasing awareness of the people are the main components for the vector control. (World Malaria Report, 2008) Although diagnosis by microscopic examination of blood films remains standard, rapid immuno-chromatographic detection of circulating parasite antigen has entered the clinical practice. These dipstick strip tests are specific, almost as sensitive as thick blood films, and simple to perform. Polymerase chain reaction testing for plasmodium antigen is most sensitive but is a research tool. [5,11]. Visceral leishmaniasis is caused by an intracellular protozoan parasite Leishmania donovan of reticulo-endothelia system of vertebrates. Kala-azar affects the spleen, liver, bone marrow, etc. and the shin become black. Bangladesh is one of the endemic countries for visceral leishmaniasis in the world, second and largest parasitic killer and also a major impediment to socio-economic development.. In last ten years, a total of 69000 cases were reported in Bangladesh of which 42,780 (62%) cases were from Mymenshingh district. In 2008, 73.6% and in 2009, 71.1% of the kala-azar cases of the country were reported from Mymenshingh (M&PDC unit DGHS). PKDL is also prevelrnt there. Bangladesh has 12 endemic districs for kala-azar and prevalent in 46 districts [6.7]. The objectives of the present investigation were to assess the knowledge, attitude and practices of technolodies for diagnosis, treatment, prevention control for kala-azar and malaria endemic and intervention areas of Bangladesh by the Formal Health care Providers. Lymphatic filariasis (LF) more commonly known as elephantiasis, is a painful and profoundly disfiguring disease. The disease is caused by thread-like worms of genus Wuchereria and Brugia, known as filaria that lodge in the lymphatic system, the network of nodes and vessels that maintain the delicate fluid balance between the tissues and blood and which are an essential component of the body's immune system. As a Neglected disease, it is a devastating obstacle to socio-economic development, because they debilitate, deform, blind and kill. It is easy to understand the significance of death rates and mortality figures. But more difficult to translate chronic disability and illness into a value that is readily understood by public health officials and advocates in relation to their contribution to poverty. Increasing urbanization is occurring gradually in low-income countries, facilitate the spread of filariasis. This is mostly due to inadequate waste disposal and sanitation facilities, which increase the number of breeding sites for the mosquito. So, filaria is transmitted through mosquitoes. When an infected mosquito takes a blood meal, the parasites are deposited on the person's skin from where they enter through the skin. These larvae then migrate to the lymphatic vessels and develop into adult worms, over a period of 6 to 12 months, causing damage and dilatation of the lymphatic vessels. The filaria live for several years in the human host.