•People living with HIV are 100 to 2,300 times more likely to develop kala-azar, caused by bites from infected female sandflies, which attacks the immune system.
•Both Kalaazar and HIV weaken the immune system and reinforce each other, leaving a person vulnerable to other opportunistic diseases like TB, malaria and dysentery.
Image: File
Patients with kala-azar, who are co-infected with HIV will now be put on treatment for the parasitic disease for 14 days instead of 38.
This follows new guidelines released by the World Health Organization for the treatment of patients with kala-azar (or visceral leishmaniasis).
Previous treatment comprised injections for 38 days and the reduction is expected to improve adherence and result in better efficacy.
According to evidence, people living with HIV are 100 to 2,300 times more likely to develop kala-azar, caused by bites from infected female sandflies, which attack the immune system.
Kala-azar and HIV co-infection is disastrous because both conditions weaken the immune system and reinforce each other, leaving a person vulnerable to opportunistic diseases like TB, malaria and dysentery.
Drugs for Neglected Diseases initiative, an international non-profit with offices in Nairobi, welcomed the new guidelines but said research for even better treatment will continue.
“The new combination treatment still relies on miltefosine, an oral drug that can potentially affect the development of the embryo in pregnant women; and liposomal amphotericin B, a drug given as an infusion that can be delicate to administer and requires hospitalisation and monitoring,” Dr Monique Wasunna, DNDi Eastern Africa regional director, in Nairobi said.
“Lengthy hospital stays or frequent ambulatory hospital visits can be challenging for some patients and may result in substantial loss of income for both patient and caregiver."
The WHO said the new recommendations are based on the results of studies conducted in India by Médecins Sans Frontières and partners, and in Ethiopia by the DNDi and partners.
Kenya’s Ministry of Health did not immediately confirm if the new guidelines are applicable in the country.
In 2020, more than 90 per cent of new cases were reported to WHO from 10 countries: Kenya, Brazil, China, Ethiopia, Eritrea, India, Somalia, South Sudan, Sudan and Yemen.
“The new WHO guideline offers hope to coinfected patients and fills an important gap in allowing countries where both diseases are prevalent to adapt the guideline for the treatment of complex clinical cases,” the WHO said in a statement.
They are expected to increase access to treatment and improve treatment outcomes, and thereby benefit national control programmes for neglected tropical diseases, HIV, tuberculosis and vector-borne diseases.
Kenya released guidelines to help reduce deaths from the kala-azar in June last year.
“Factors that increase the risk of developing the disease include young age, malnutrition, immunosuppressive diseases such as HIV, malignancies and organ transplantation,” the guidelines say.
Rashid Aman, Health CAS, said that five million Kenyans, mainly children aged 5-14 are at risk of the disease, mostly in nine Arid and Semi-Arid parts of the country.
He said that 607 cases of visceral leishmaniasis, parasites that are spread by the bite of sand flies, were reported in 2018, while 1,463 and 1, 211 respectively were reported in the year 2019 and 2020.
(Edited by Tabnacha O)