Outbreak of kala azar in Marsabit County

25th July 2014

We have received reports of outbreak of kala azar in Marsabit County. Below you can read about Leishmaniasis (kala azar) and how to prevent the disease.

Leishmaniasis is caused by a protozoa parasite Leishmania species. It is transmitted through the bites of infected female phlebotomine sandflies. Worldwide an estimated 1.3 million new cases and 20 000 to 30 000 deaths occur annually. There are three main forms of the disease:

  • Visceral leishmaniasis (also known as kala-azar) is fatal if left untreated. It is characterized by irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anaemia. It is highly endemic in the Indian subcontinent and in East Africa.
  • Cutaneous leishmaniasis is the most common form of leishmaniasis and causes ulcers on exposed parts of the body, leaving life-long scars and serious disability. About 95% occur in the Americas, the Mediterranean basin, and the Middle East and Central Asia.
  • Mucocutaneous leishmaniasis leads to partial or total destruction of mucous membranes of the nose, mouth and throat. Almost 90% occur in Bolivia, Brazil and Peru.

Risk factors
The disease mainly affects poor communities and is associated with malnutrition, population displacement, poor housing, a weak immune system and lack of resources. Sandflies are attracted to crowded insanitary areas and easily bite those sleeping outside or on the ground. Diets lacking protein-energy, iron, vitamin A and zinc increase the risk that an infection will progress to kala-azar. Epidemics may be associated with movement of non-immune people into areas with existing transmission. Rainfall and temperature changes may increase transmission. Environmental changes such as deforestation, building of dams, irrigation schemes, urbanization and incursion of agricultural farms and settlements into forested areas have been implicated. Occupational exposure is an important factor.

Diagnosis and treatment
Diagnosis is made by combining clinical signs with parasitological or serological tests. The treatment of leishmaniasis depends on type of disease, parasite species and geographic location. Leishmaniasis is a treatable and curable disease. All patients diagnosed as visceral leishmaniasis require prompt and complete treatment.

Prevention of leishmaniasis requires a combination of intervention strategies because transmission occurs in a complex biological system involving the human host, parasite, sandfly vector and in some cases an animal reservoir.

  • Early diagnosis and effective treatment reduces the burden of the disease and prevents disabilities and death. There are effective and safe medicines and access can be improved.
  • Vector control helps to reduce transmission of disease by controlling sandflies. Control methods include insecticide spray, use of insecticide–treated nets, environmental management and personal protection.
  • Effective disease surveillance is important. Early detection and treatment of cases helps reduce transmission and helps monitor the spread and burden of disease.
  • Social mobilization and strengthening partnerships – mobilization and education of the community with effective behavioral change interventions with locally tailored communication strategies in collaboration with various stakeholders for control of vector-borne diseases.