More counties report cases of Kala-azar

Experts have expressed concern over the steady rise in the number of reported cases of leishmaniasis in the country.

Data from the Health Ministry show that the number of cases of the disease, also known as Kala-azar, rose from 907 in 2018 to 1,463 in 2019 before dropping to 1,200 last year.

The disease that was believed to be prevalent in just six counties is now said to be in at least 11 counties.

Recent reports indicate that Kajiado and Tharaka Nithi have also reported some cases.

Head of Division of vector-borne and neglected tropical diseases at the Ministry Sultani Matendechero now says that at least 11 counties are experiencing ongoing transmission of the disease.

They include Marsabit, Mandera, Garissa, Turkana, West Pokot, Baringo, Isiolo, Wajir, Kitui, Nakuru and Nyandarua.

Kenya now plans to reduce the number of cases by at least 60 per cent and reduce the incidence by 50 per cent in the next five years.

Kala-azar is classified as a neglected tropical disease and is caused by infection with Leishmania parasites, which are spread by the bite of phlebotomine sand flies.

“For a very long time people were suffering from Leishmaniasis especially in the arid and semi-arid areas but for some reason we were not able to detect and determine that it is leishmaniasis that is making people fall sick, killing them and making them unable to attend to their economic activities,” Matendechero said.

The ministry on Monday launched the first strategic plan for control of leishmaniasis 2021-2025 that aims to guide the control and management of the disease and work towards elimination as a public health concern.

“We are not sure if these are the only counties that have leishmaniasis so as a programme one of the things that now we are reaching out to do in this strategy is to be able to correctly determine all the areas in the country where leishmaniasis is endemic so that we can be able to effectively bring it under control,” he said.

The disease presents in two forms, visceral leishmaniasis and cutaneous leishmaniasis.

Visceral leishmaniasis, also known as Kala-azar, is a chronic and potentially fatal disease of the viscera (particularly the liver, spleen, bone marrow and lymph nodes).

It attacks vital organs leading to failure. If left untreated, it can lead to death within two years with a fatality rate of 95 per cent.

Cutaneous leishmaniasis on the other hand is an immune-mediated skin pathology caused by the bite of sandflies infected with the Leishmania parasite.

It is characterised by skin lesions, mainly ulcers on exposed parts of the body, leaving life-long scars and serious disability.

Kenya has reported 53 cases of cutaneous leishmaniasis in the counties of Nakuru and Nyandarua this year.

“The strategy will guide the control and management of leishmaniasis with a focus on disease ecology and mapping, case identification and management, health systems strengthening, surveillance and vector control,” Health CAS Rashid Aman said.

According to the World Health Organisation, more than 90 per cent of new cases reported to them in 2019 occurred in 10 countries: Nepal, Iraq, Brazil, Eritrea, Ethiopia, India, Kenya, Somalia, South Sudan and Sudan.

The agency estimates that 50,000 to 90,000 new cases of VL occur worldwide each year with 25-45 per cent reported to the WHO.

The treatment of leishmaniasis depends on the type of disease, concomitant infections, parasite species and geographic location.

It is treatable and curable, and requires an immunocompetent system.

In Kenya, the nationally recommended first-line treatment of VL is Paromomycin and Sodium Stibogluconate Combination Therapy while AmBisome is the 2nd line treatment for special VL cases as specified in the revised national guidelines.

Edited by Kiilu Damaris