Sustaining the Elimination of Visceral Leishmaniasis: A Secondary Data Analysis of the National Kala-Azar Elimination Programme in Malda District, West Bengal, India (2018-2022).

Background Visceral leishmaniasis (VL), commonly known as kala-azar, remains a public health concern in several endemic regions of India. Sustaining elimination requires continuous surveillance and programmatic monitoring. This study assessed the progress of the National Kala-Azar Elimination Programme in Malda district, West Bengal, during 2018-2022. Methods A descriptive cross-sectional study based on secondary analysis of routine programme data was conducted using records maintained by the Chief Medical Officer of Health, Malda. Data on VL and post-kala-azar dermal leishmaniasis (PKDL) cases, mortality, active case detection, treatment outcomes, vector control activities, and logistics management were extracted and analysed using Microsoft Excel 2019 (Microsoft Corporation, Redmond, WA). Descriptive statistics were used to summarize trends and programme performance indicators. Results VL cases declined from 19 in 2018 to seven in 2022, indicating sustained control of disease transmission. In contrast, PKDL cases increased from 40 in 2018 to 55 in 2022 and constituted the majority of reported kala-azar cases in 2022. Adults aged >15 years accounted for 89.9% of VL cases and 92.2% of PKDL cases. Males represented the majority of cases in most years, while tribal populations contributed 40-71% of annual reported cases. All 15 endemic blocks maintained the elimination target throughout the study period, with 11 blocks reporting no VL cases in 2022. Treatment completion exceeded 90% annually, indoor residual spraying achieved population coverage above 91%, and active case detection continued to identify confirmed cases among screened populations. Conclusion Malda district successfully sustained kala-azar elimination status throughout the study period. Continued surveillance, early detection and treatment of PKDL, follow-up of treated VL patients, and targeted interventions in tribal and historically endemic areas are essential to prevent resurgence and sustain elimination gains.