"Thousands of people, mostly poorest of the poor, in over 11,000 villages in Bihar have been affected by Kala azar and nearly 35 million others are at risk of contracting the disease," an official of MSF or Doctors Without Borders said on the basis of its latest report released on Monday.

According to MSF - an international humanitarian-aid non-governmental organisation - Bihar is the epicentre of Kala azar in India as 33 of its districts are affected by the disease. Kala azar is spreading its tentacles despite regular immunisation programme taken up across the state, the MSF said.

"The poorest of the poor living in impoverished condition fall an easy victim to the disease," the MSF added. Bihar Health Minister Ramdhani Singh told reporters that the Nitish Kumar government was committed to eliminate Kala azar from the state. "We have been working to make Bihar kala azar-free state," Singh said.

He cited special programmes were launched in all affected districts to check and control sand fly that caused Kala-azar and also to create awareness about preventive steps among the people, mostly the poorest of the poor, in affected districts. kala-azar, known medically as visceral leishmaniasis, is also known as the poor man's disease.

Bihar last faced a kala-azar epidemic in 1991 when 250,000 cases were reported. In 2000, the numbers were low but began rising from 2003 onwards. The disease occurs in 62 countries, primarily in the developing world. Around 90 percent of world's cases are found in India, Bangladesh, Nepal and Sudan.

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