Forgotten diseases loom as attention turns to Covid-19

Experts warn Kenya to expect more cases of measles, HIV and worse cancer outcomes

In Summary
  • At least seven million susceptible children have not received booster doses for measles since 2016.
  • Experts also warn new HIV infections will rise, due to the ongoing shortage of drugs to treat and prevent infections. 
Health CS Sicily Kariuki during a past immunisation drive.
MEASLES AND RUBELLA: Health CS Sicily Kariuki during a past immunisation drive.

Outbreak of several dangerous diseases loom beyond the Covid-19 pandemic. 

Experts have taken to scientific journals to warn the prevalence of 'forgotten' diseases such as measles, cancer and HIV will rise rapidly in Kenya.

For instance, at least seven million susceptible children have not received booster doses for measles since 2016.

A nationwide drive first due in February 2019 was postponed over lack of funds, then by the Covid-19 pandemic last year.

"Measles is unforgiving of immunity gaps and is certain to resurge after the Covid-19 pandemic," says Kenya Paediatrics Association head David Githanga in an article he co-authored in Nature Medicine journal. 

Measles virus is the most infectious virus on the planet.

The authors note the disease's reproduction number of 12–18 (the average cases one case generates over the course of that case’s infectious period in a susceptible population) far exceeds that of other emerging viruses, including SARS-CoV-2, which has a reproduction number of 2.5–3.5.

Head of Kenya's National Vaccines and Immunisation Programme Collins Tabu also noted the country faces a higher risk of measles outbreak.

His warning is contained in a new study he co-authored last month in BMC Medicine journal, titled "The importance of supplementary immunisation activities to prevent measles outbreaks during the Covid-19 pandemic in Kenya."

The authors place the probability of a large measles outbreak in Kenya this year between 38 per cent and 54 per cent depending on vaccination coverage.

“However, the increased risk of a measles outbreak following the lifting of all Covid-19 restrictions can be overcome by conducting a SIA (supplementary immunisation activities) with more than 95 per cent coverage in under-fives,” they say.

The Ministry of Health is said to be planning a mass measles and polio vaccination campaigns this year.

A mass polio vaccination campaign was lastly planned for mid-last year but was also postponed due to the outbreak of Covid-19.

Dr Josephine Ojiambo, a community medicine and public health specialist, said 11 counties have the greatest risk of outbreak of vaccine-derived polio because of a build-up of thousands of under-immunised children.

“Most of these children come from poor families, urban informal settlements, and hard-to-reach parts of the country, particularly arid and semi-arid regions, where access to health services is limited,” she said in Nairobi in October last year during a joint polio immunisation exercise between Rotary Kenya and Gertrude’s Children’s Hospital at Githogoro slums.

Vaccination to prevent cervical cancer has also been disrupted. 

Kenya introduced the HPV vaccine in October 2019 targeting 800,000 girls in one year.

But the country had managed to reach just slightly above 360,000 girls in December last year.

In January, Dr Tabu told the Star that the Covid-19 containment measures had contributed to the attainment of low numbers than had been anticipated.

“It is largely because much as the vaccine is being offered in every health facility, the other aspect is that the targeted outreaches for the vaccine were to be conducted jointly with schools but schools were closed due to the pandemic,” he said.

Experts also warn new HIV infections may rise, due to the ongoing shortage of drugs to treat and prevent infections. 

The stand-off comes after Usaid, who sponsors the commodities, eschewed Kemsa and sent ARVs and test kits to Kenya through a private US company, Chemonics International.

As a result, a Sh1.1 billion consignment has been lying at the port since January 18 after being handed a Sh90 million tax bill.

Usaid also wants to establish its own, parallel drug distribution system in Kenya through Chemonics instead of using Kemsa.

The Kenyan government and civil society are against this.

Some of the commodities being held include HIV testing, treatment and prevention commodities such as ARVs, laboratory reagents as well as TB diagnostic and prevention medications.

-Edited by Sarah Kanyara