Kala azar, also known as visceral leishmaniasis, has been surging in northeastern Kenya’s Marsabit and Wajir counties since late 2024, with children under 5 years old most affected. Strained health care systems, limited diagnostics and treatment resources, and low public awareness are hindering effective prevention and the broader response to the already-neglected disease.
Doctors Without Borders/Médecins Sans Frontières (MSF) emergency teams have been helping local health authorities respond, training Ministry of Health workers on case identification and management, and also conducting community health education on disease prevention activities. MSF also provided testing kits to enhance diagnosis, distributed 5,877 mosquito nets, and donated 10 insecticide sprayer pumps.
What is kala azar?
Kala azar is a deadly parasitic disease that attacks the immune system, and is transmitted by the bite of infected sandflies, which thrive in the hot, arid landscapes of northern Kenya. It is also a neglected tropical disease. Sheep and cattle farmers in this region face a higher risk of contracting kala azar because they have more exposure to sandflies.
Left untreated, the disease is fatal in 95 percent of cases, making it the second deadliest parasitic disease after malaria.
There is a worldwide shortage of both test kits and medication to effectively treat kala azar. This hindered timely treatment and disease control in affected communities at the start of surge.
“Kala azar is deadly, difficult to detect especially with limited test kits, and poorly understood by most communities,” said Dr. Barbara Amonde, MSF emergency medical lead in Marsabit. Dr. Amonde added that treatment for the disease requires extremely strong drugs and a strict regimen. “If the disease is wrongly diagnosed, the risk of poisoning and death to patients is real.”
“In previous years, we had cases from two areas, but we are now seeing cases across the whole county, with children under 5 and adult men most affected,” explained Abdiya Gewada, neglected tropical diseases coordinator in Marsabit county.
“Getting testing kits and even medications within the country have been difficult,” said Hussein Mohammed, acting neglected tropical disease coordinator in Wajir County, which has seen the highest number of cases in the country. Lack of knowledge about diagnosis among health care workers “reduced the capacity to respond quickly at the initial stages of the surges,” Mohammed added.
Neglected tropical diseases need more attention
The surges in Wajir and Marsabit demonstrate the human impact of neglected diseases like kala azar. Limited access to diagnostic tools, toxic treatment regimens that require expert handling, and low public awareness are just some of the obstacles in tackling this neglected disease.
“This outbreak is a reminder that neglected diseases do not just affect health, they expose deep inequalities in health care access,” said Maureen Muchanga, MSF medical team lead in Wajir. “Without proper vector control, accurate diagnosis, affordable treatment, and enough trained health care workers, kala azar detection and care remain delayed and difficult.”
MSF calls for increased national and international attention on neglected tropical diseases, including training for health workers, improved funding for diagnostics, safer treatments, community awareness, and prevention.
After two and a half months of support, MSF’s team has left Marsabit County, with all health activities now fully managed by the Marsabit County Health Department. The MSF team in Wajir is continuing to support treatment at the Wajir County Referral Hospital and Griftu Sub-County Hospital.
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