Govt. steps up fight against Leishmaniasis

NAIROBI, Kenya, 7 March 2017 – The Ministry of Health is setting up a comprehensive national data management system where health workers can report incidences of Leishmaniasis. The project which is supported by the World Health Organization (WHO) is expected to determine the country’s Leishmaniasis disease burden and inform appropriate interventions.

Speaking in Nairobi on Tuesday, Head of the Neglected Tropical Diseases (NTDs) Unit Dr. Sultani Matendechero explained that the reporting system will boost Kenya’s efforts against the deadly disease by raising the level of awareness and mapping out all the endemic areas.

He observed that Leishmaniasis is currently reported in Baringo, Isiolo, Marsabit, Nakuru,Nyandarua, Turkana, Wajir and West Pokot Counties however, the factual disease burden is still unknown. According to Dr. Matendechero, the lack of data has similarly made it difficult for Kenya to pitch for donor support in the fight against Leishmaniasis.

“In most NTD programmes we partner with people and have to give evidence and justification for the support that we are requesting for. We rely on data. So we have experienced quite a big problem this far.  As much as we know that Leishmaniasis is a big problem in the country, we are not able to show in terms of data how big the problem is,” he said.

Dr. Matendechero added that the data will help the government to invest appropriate resources at both national and community levels to end Leishmaniasis. This includes medicine; test kits; skilled work force; increased surveillance and health education. The data will also help health workers to know which indicators to look out for.

Dr. Jose Ruiz Postigo, who is a Medical Officer at WHO’s Leishmaniasis Control Programme Innovative and Intensified Disease Management Department of NTDs revealed that there about two million new cases of Leishmaniasis in the world every year. He noted that the disease is most prevalent in India’s Bihar state which accounts for 80 percent of all the cases in the world.

In addition, Leishmaniasis is prevalent in Nepal and Bangladesh. It is also endemic to Ethiopia, Sudan and South Sudan which are classified as high burden countries. Kenya, Somalia and Uganda are classified as low burden.

“Kenya is competing with high burden countries and donors give funds to the three high burden countries in Eastern Africa. However two years ago we had a meeting and WHO committed to look for funds for these low burden countries. In September 2016, an agreement was signed with a donor for five years so we now have funds that can be allocated to Uganda, Kenya and Somalia,” he explained.

Dr. Postigo added that WHO will use the resources secured to train care givers, health records and information officers at health facility level on how to treat; diagnose; enter and analyze data according to the new Kenyan guidelines. “Without data we cannot take action or make decisions. That’s why we had to agree on standard reporting forms for Leishmaniasis and to have it digitized through the DHIS2 National Reporting System,” he said.

Leishmaniasis is transmitted through the bite of an infected female sand fly and comes in three forms according to WHO. Two of these forms are endemic to Kenya; that is Cutaneous Leishmaniasis and Visceral Leishmaniasis which is also known as Kala-azar. While Cutaneous Leishmaniasis causes lesions on the skin, Kala-azar affects the liver and spleen resulting in death if left untreated.

Kenyans living in Nyandarua and Nakuru Counties are prone to Cutaneous Leishmaniasis. This is largely associated with the presence of bush and rock hyraxes in these regions; high levels of charcoal burning and caves. Bush and rock hyraxes are believed to provide natural reservoirs for the parasites that cause Cutaneous Leishmaniasis.

On the other hand, Kala-azar is endemic to the arid and semiarid areas of Baringo, Isiolo, Marsabit, Turkana, Wajir and West Pokot Counties. Sand flies can be found in ant hills and termite mounds that are common in these areas.

To treat Cutaneous Leishmaniasis, one must get daily injections of Sodium Stibogluconate (SSG) for more than 60 days depending on how fast the lesions heal. To treat Kala-azar one must get a combined injectable therapy of SSG and Paromomycin for 17 days.

Other than WHO, the Ministry of Health has been working with Drugs for Neglected Diseases Initiative (DNDI), Izumi Foundation and the School of Public Health University of Nairobi. DNDI has tried to make affordable treatment available and has supported research through the Kenya Medical Research Institute (KEMRI).

DNDI has also been supporting the KEMRI-Kimalel Leishmaniasis Treatment Centre in Baringo County as well as the Kacheliba Health Centre in West Pokot.