Battling Kala-Azar: A Silent Epidemic Threatening Turkana County

In the arid heart of Turkana County, Kenya, Lodwar County Referral Hospital (LCRH) serves as a beacon of hope for families grappling with kala-azar, a deadly yet neglected disease. The hospital's children’s ward, sweltering under the relentless sun, is a somber reminder of the region's ongoing fight against this parasitic illness.

A Disease That Strikes Quietly

Kala-azar, also known as visceral leishmaniasis, is often called the "silent killer" due to its vague symptoms—fever, fatigue, weight loss, and appetite loss—that mimic other common illnesses like malaria. Left untreated, the disease is fatal in 90% of cases. It is caused by Leishmania parasites transmitted through sandfly bites, which thrive in sandy environments like anthills and Acacia forests. For Turkana’s pastoralist communities, whose livelihoods keep them outdoors at night, the danger is ever-present.

The Human Toll

Caregivers at LCRH, like Pamela Ekutan, witness the devastating impact of kala-azar. Ekutan’s five-year-old son, Lomoe, has spent two weeks in the hospital. “It started like malaria,” she recalls. “After local treatments failed, we came here and learned it was kala-azar.”

The hospital is overwhelmed, with clinicians like Kennedy Wasilwa diagnosing five to ten cases daily. Many arrive in advanced stages, suffering from severe anemia, tuberculosis, or other complications. Treatment begins with stabilization before administering a 17-day regimen of sodium stibogluconate and paromomycin, costing an average of KES 30,000 ($234) per patient.

A Growing Crisis

In Turkana County, kala-azar cases have surged, with reported cases climbing from 157 in 2018 to over 400 by 2020. Despite some progress, the disease’s high fatality rate remains a pressing concern. Children are disproportionately affected, comprising up to 70% of cases. Their vulnerability stems from malnutrition and weaker immune systems, according to health experts like Cherinet Adera of DNDi Nairobi.

Fighting Back: Prevention and Treatment

Efforts to combat kala-azar are ramping up. The Ministry of Health has partnered with organizations to implement outreach programs, distribute insecticide-treated nets, and enhance diagnostic tools. Public education campaigns aim to raise awareness about the disease and its transmission, particularly among high-risk groups like pastoralists.

The World Health Organization (WHO) has set an ambitious goal: eliminate kala-azar as a public health threat by 2030. The plan includes better diagnostics, integrated HIV treatment for co-infected patients, and a reduction in misdiagnoses. Success stories, such as Bangladesh's elimination of the disease in 2023, offer hope that this goal is attainable.

Stories of Survival

For families like that of Nangiro Loyopo, whose eight-year-old son Esekon is undergoing treatment, the fight against kala-azar is personal. Loyopo, a pastoralist, left his work to stay by his son’s side. “We’ll use mosquito nets and stay vigilant when we return home,” he says, reflecting on the lessons learned during this ordeal.

A Path Forward

The battle against kala-azar in Turkana County is far from over. However, with improved treatments, preventive measures, and the resilience of affected communities, progress is within reach. Collaboration between local and international health organizations is crucial to turning the tide against this silent epidemic.

As Turkana’s health workers, caregivers, and families continue their fight, their determination signals a brighter future—one where no child’s life is lost to kala-azar.