Wellness & Fitness

Neglected tropical disease, Kala-azar, takes a heavy toll


Children recuperate in the Kala-azar ward at Kimalel Health Centre in Baringo County. FILE PHOTO | NMG

Mary Nawoi* arrives at Lodwar Referral Hospital breathing heavily. She has brought her six-year-old grandson for treatment.

Mary is a rugged looking elderly woman in her 60s with sharp penetrating gaze and deeply wrinkled forehead. She is from Naita Arengan in Turkana North, 230 Kilometres from Lodwar Town.

The grandson was thin and tall with a distended abdomen and an old grey piece of clothing covering his torso.

She is ushered to a doctor’s consultation room.

“My grandson is suffering. This disease has eaten him up to the bone. Whatever it is, it is causing me heartache. I lost his father two years ago with the same symptoms,” she says with a deep tinge of sorrow and weariness in her voice.

Dr Gilchrist Lokoel, epidemiologist, chief executive officer, Lodwar Referral Hospital, who attended to the boy said he had general abdominal distension, fever, general body weakness and body-wasting.

“On physical examination, I found out the spleen was markedly enlarged, reaching the umbilical area. His blood level was also low,” says Dr Lokoel.

Based on these findings, Dr Lokeol ordered full haemogram and kalaazar test that came out positive. Unfortunately, the boy succumbed before he could start his 30 days anti- kala azar injections

In the semi-arid area of Turkana County, the landscape is dotted with numerous anthills; some grow to be as tall as eucalyptus trees.

Herdboys and men occasionally take shelter under these anthills to protect themselves from the hot scorching sun. Unknown to them, there are insects called sand flies that hide inside these ant hills that bite them, infecting them with a disease called kala-azar that if left untreated, normally leads to 100 per cent mortality

Kala- azar is one of the 18 diseases that the World Health Organisation (WHO) classifies as “neglected tropical diseases” (NTDs), since everyone including the government neglects them.

Dr Sultani Matendechero, the Head of Neglected Tropical Diseases at the Ministry of Health, reported that kala-azar threatens more than 600,000 people in Turkana, West Pokot, Baringo, Isiolo, Marsabit and Wajir.

In Kenya, kala-azar and other 14 NTDs are a public health concerns.

NTDs have killed, maimed and impoverished many Kenyans because of the little attention paid to them.

Dr Matendechero states that initial symptoms of kala-azar include fever, general body weakness and anaemia. The patients can present a swollen abdomen, skin ulcers and recurrent nosebleeds.

The symptoms start showing between two to three months after being bitten by an infected sand fly.

The government of Kenya in collaboration with the World Health Organisation in 2016 came up with a National Strategic Plan for Control of Neglected Tropical Diseases that was to run until 2020 purposely to rally funds to eradicate the diseases.

However, researchers have pointed out various challenges that need to be addressed in case the country is geared towards eradication of the NTDs

Dr Monique Wasunna, Director Drugs for Neglected Diseases Initiative (DNDi) Africa, says lack of statistics on the burden of neglected tropical diseases in East Africa, low budgetary allocation amongst the countries and inappropriate testing kits are to blame for high prevalence.

“The diseases pose a huge economic and health burden to countries and mostly they affect poverty-stricken communities who live far away from the hospital. Patients die at home and the data is not recorded. This makes it very difficult to get to know how dangerous the diseases are making it very difficult for countries to prioritise them,” she says.

She says the diseases including soil-transmitted helminthiasis (STH) which are intestinal worms, bilharzia, lymphatic filariasis (elephantiasis), trachoma, kala- azar and rabies are fatal if not treated and needs urgent attention.

She said that had Mary made it to the hospital on time, the boy would have had a 95 per cent chance of surviving.