Characterization of visceral leishmaniasis outbreak, Marsabit County, Kenya, 2014

Kanyina, Evalyne

doi:10.1186/s12889-020-08532-9

Cited by 17 publications

(16 citation statements)

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“…The sand fly-borne disease leishmaniasis, constitutes a public health problem in eastern Africa including Sudan, Ethiopia, Uganda, Kenya, and Somalia [ 1 ]. Leishmaniasis ranks among the priority list of zoonotic diseases for control in Kenya [ 2 ] where an estimated 4000 human cases of the visceral form (VL) of the disease occurs, with about 5 million at risk of infection [ 3 ]. Current control of leishmaniasis relies on prompt diagnosis and chemotherapeutic treatment.…”

Section: Introductionmentioning

confidence: 99%

“…However, these approaches have not prevented the spread of the disease across Kenya. Visceral leishmaniasis has expanded in geographic range with frequent recent outbreaks as the cutaneous form (CL) of the disease [ 3 ]. New tools are therefore urgently needed with emphasis on disease prevention through effective management and control of the sand fly vectors.…”

Section: Introductionmentioning

confidence: 99%

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Afrotropical sand fly-host plant relationships in a leishmaniasis endemic area, Kenya

et al. 2021

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The bioecology of phlebotomine sand flies is intimately linked to the utilization of environmental resources including plant feeding. However, plant feeding behavior of sand flies remains largely understudied for Afrotropical species. Here, using a combination of biochemical, molecular, and chemical approaches, we decipher specific plant-feeding associations in field-collected sand flies from a dry ecology endemic for leishmaniasis in Kenya. Cold-anthrone test indicative of recent plant feeding showed that fructose positivity rates were similar in both sand fly sexes and between those sampled indoors and outdoors. Analysis of derived sequences of the ribulose bisphosphate carboxylase gene large subunit (rbcL) from fructose-positive specimens implicated mainly Acacia plants in the family Fabaceae (73%) as those readily foraged on by both sexes of Phlebotomus and Sergentomyia. Chemical analysis by high performance liquid chromatography detected fructose as the most common sugar in sand flies and leaves of selected plant species in the Fabaceae family. Analysis of similarities (ANOSIM) of the headspace volatile profiles of selected Fabaceae plants identified benzyl alcohol, (Z)-linalool oxide, (E)-β-ocimene, p-cymene, p-cresol, and m-cresol, as discriminating compounds between the plant volatiles. These results indicate selective sand fly plant feeding and suggest that the discriminating volatile organic compounds could be exploited in attractive toxic sugar- and odor- bait technologies control strategies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Afrotropical sand fly-host plant relationships in a leishmaniasis endemic area, Kenya

et al. 2021

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“…Since its first report in 1935, there have been several epidemics of VL in Kenya, including in the previously unaffected areas of Wajir and Mandera during 2000–2001 ( 80 ). It is expected that there are around 4,000 cases of VL annually ( 84 ). Over 5 million people in Kenya are considered at risk of exposure to leishmaniasis, with an incidence rate of 2.96 per 10,000 people for VL, however, incidence rate for CL is not reported ( 84 , 85 ).…”

Section: Kenyamentioning

confidence: 99%

“…It is expected that there are around 4,000 cases of VL annually ( 84 ). Over 5 million people in Kenya are considered at risk of exposure to leishmaniasis, with an incidence rate of 2.96 per 10,000 people for VL, however, incidence rate for CL is not reported ( 84 , 85 ).…”

Section: Kenyamentioning

confidence: 99%

Leishmaniasis Beyond East Africa

Jones

Welburn

2021

Front. Vet. Sci.

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Climate change is having a substantial impact on our environment and ecosystems and has altered the way humans live, access, and utilize resources with increased risk of zoonotic infectious disease encounters. As global temperatures continue to increase, they impact on public health, migration, food security and land conflict, and as new environments become favorable, exposure to disease carrying vectors. Increased forests or natural habitat clearance for land repurposing, urbanization, road building, and water management are related to an increase in emerging vector borne parasitic diseases. The East African region remains one of the most impacted regions globally for leishmaniasis, a vector borne disease that impacts significantly on the health, wellbeing and livelihoods of affected communities and for which a lack of reporting and control interventions hinder progress toward elimination of this neglected tropical disease. As our world continues to transform, both politically and climatically, it is essential that measures are put in place to improve surveillance and disease management with implementation of control measures, including vector control, especially in low- and middle-income countries that are expected to be most impacted by changes in climate. Only through effective management, now, can we be sufficiently resilient to preventing the inevitable spread of vectors into suitable habitat and expansion of the geographical range of leishmaniasis. This review offers a current perspective on Leishmaniasis as an endemic disease in East Africa and examines the potential of the recent emergence of Leishmania infection in hitherto unaffected regions to become a public health concern if no disease management is achieved.

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“…Three outbreaks have been registered in recent years: in 2014 (8), 2017 (9), and 2019 (10). In 2014 and 2017 (8,11), most of the VL cases were diagnosed and treated in two health facilities: Marsabit County Referral Hospital and Laisamis Sub-County Hospital, with 5 other facilities also contributing to VL diagnosis. During the outbreak in 2019, additional treatment facilities were also created.…”

Section: Introductionmentioning

confidence: 99%

Strengthening Visceral Leishmaniasis Diagnosis Capacity to Improve Access to Care in Kenya: The Example of Marsabit County

Souza

Picado

Bessell³

et al. 2022

Front. Trop. Dis

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BackgroundVisceral leishmaniasis (VL), also known as kala-azar, is a neglected tropical disease (NTD) that is fatal if not treated early. The WHO targets the elimination of VL as a public health problem in its 2030 NTD road map. However, improving access to VL diagnosis and treatment remains a major challenge in many VL-endemic countries. Kenya is endemic for VL and is among the top 6 high-disease burden countries in the world.MethodsFIND, through its activities in improving the diagnosis of VL and supporting the elimination of the disease in Kenya, has worked with various county ministries of health (MOH) and central MOH over the last couple of years. FIND’s activities in Marsabit county started in 2018. In this work, we present the implementation of activities and the impacts in Marsabit county. We reviewed the data for 2017 and 2019 outbreaks (before and after the implementation of FIND’s activities) and assessed the importance of improving access and community sensitization to VL diagnosis. We assessed the contribution of each facility to the total distance traveled from a perspective of location optimization.ResultsThere was a sharp increase in the number of people tested in the 2017 outbreak compared to the 2019 outbreak. In 2017, 437 people were tested compared to 2,338 in 2019. The county reported 234 and 688 VL cases in 2017 and 2019, respectively. The data revealed a shift in the demographic structures of cases toward the younger population (mean age in 2017 was 17.6 years and 15.3 years in 2019), with more female cases reported in 2019 compared to 2017. In 2017, 44.4% were 10 years of age or under. In 2019, the proportion 10 years or below was 52.2%. The addition of two new diagnosis facilities in 2018 resulted in a decrease in the distance traveled by confirmed VL cases from 28.1 km in 2017 to 10.8 km in 2019. Assessing the impact of facility placement indicated the most optimal facilities to provide VL diagnostic services and minimize the distance traveled by patients. Adding new facilities reduces the travel distance until a point where the addition of a new facility provides no additional impact.ConclusionThe results from this study indicate the need to carefully consider the placement of health facilities in improving access to VL diagnosis and treatment and could serve as an investment case in deciding when to stop adding new facilities in a particular setting. Extending the activities in Kenya to other VL-endemic countries in East Africa will contribute significantly toward the elimination of the disease, addressing the needs of marginalized populations and leaving no one behind.

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Characterization of visceral leishmaniasis outbreak, Marsabit County, Kenya, 2014

Cited by 17 publications

References 18 publications

Afrotropical sand fly-host plant relationships in a leishmaniasis endemic area, Kenya

Afrotropical sand fly-host plant relationships in a leishmaniasis endemic area, Kenya

Leishmaniasis Beyond East Africa

Strengthening Visceral Leishmaniasis Diagnosis Capacity to Improve Access to Care in Kenya: The Example of Marsabit County

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