Visceral leishmaniasis outbreak in Wajir County, Kenya, 2018

Abstract

Background: Visceral leishmaniasis (VL) has been endemic in Wajir County since 1935.
Objective: This study determined the magnitude of the 2017–2018 VL outbreak, assess healthcare workers (HCWs) and the community’s knowledge, attitude, and practice on VL prevention and control measures.
Method: We retrospectively reviewed 217 patient records from January 2017 to January 2018, and used structured questionnaires to interview HCWs and residents for KAP survey. Frequencies, proportions, and attack rates were calculated, and the data presented in tables and figures.
Results: A total of 217 cases were line-listed with four deaths, a case fatality rate (CFR=1.8), and an attack rate of 25.4/100,000 persons. Males were 145(67%) and 125(58%) were children <5 years old. Of 212(98%) tested using rk39, 95(45%) tested positive, 154(71%) received treatment of which; 143(66%) completed, 7(3.2%) were on treatment during the study and 4(2%) had defaulted. Seventy residents were interviewed; all had heard of VL, and locally identified it as deqsi, abdominal distension 65(93%) and fever 61(87%) were the major signs and symptoms reported, 69(99%) believed VL is curable and 39(56%) didn’t know nor practiced any prevention and control measures. Twenty HCWs were interviewed: All had heard of VL, knew major signs and symptoms, and mentioned VL treatment was effective. Eight (40%) associated VL with poverty, and 19(95%) offered patient counselling.
Conclusion: VL persisted year throughout, mostly affecting males and children < 5 years. Communities’ awareness of VL was high. We recommend strengthening the health system to ensure the effectiveness and sustainability of the interventions provided.