{"id":60068603,"date":"2025-01-21T14:48:36","date_gmt":"2025-01-21T14:48:36","guid":{"rendered":"https:\/\/dialogue.earth\/?p=60068603"},"modified":"2025-01-31T11:59:16","modified_gmt":"2025-01-31T11:59:16","slug":"climate-change-is-fuelling-leishmaniasis-in-northern-kenya","status":"publish","type":"post","link":"https:\/\/dialogue.earth\/en\/climate\/climate-change-is-fuelling-leishmaniasis-in-northern-kenya\/","title":{"rendered":"Climate change is fuelling leishmaniasis in northern Kenya"},"content":{"rendered":"\n

Ekidor Kiyong is only 15 years old, but he has already had a close encounter with a deadly disease. A herder from Turkana, northern Kenya, he is coming to the end of his treatment for kala-azar, which is spread through the bites of infected sandflies.<\/p>\n\n\n\n

His aunt, Ester Loskiria, has accompanied him to Lodwar County Referral Hospital. She tells Dialogue Earth that the disease, also called visceral leishmaniasis, began with malaria-like symptoms \u2013 fever, headache, fatigue, loss of appetite.<\/p>\n\n\n\n

\u201cHe\u2019s getting better now,\u201d she says with relief, before adding that the KES 30,000 (USD 230) cost of his treatment is a large burden for the family.<\/p>\n\n\n\n

If left untreated, kala-azar is fatal in 95%<\/a> of cases, according to the World Health Organization (WHO).<\/p>\n\n\n\n

The WHO describes the disease as climate-sensitive<\/a>, partly because changes in temperature, rainfall and humidity can have a big impact on sandfly numbers. Sandflies can breed and thrive<\/a> in deeply cracked soil, for example, which is increasingly prevalent as the climate warms. Deforestation for firewood is another problem, as the flies also thrive in sandy, degraded land.<\/p>\n\n\n\n

The disease is endemic in Kenya\u2019s Rift Valley, eastern and north-eastern regions, according to a 2024 Lancet article<\/a>. Reported cases have been increasing<\/a> in the country in recent years, with 607 in 2018 and 1,463 in 2019. The Lancet puts the annual reported figure at 1,600, with 170 deaths, though the actual number of cases is likely to be far higher.<\/p>\n\n\n\n

Kenya\u2019s Turkana<\/a>, a semi-arid county in the Rift Valley, is particularly badly affected. The spread there highlights a stark intersection between health and environmental justice. Sometimes referred to as the \u201cforgotten disease<\/a>\u201d, kala-azar disproportionately affects communities already grappling with poverty, limited healthcare access and worsening climatic conditions. The situation shows how the poorest and most marginalised communities often bear the brunt<\/a> of environmental degradation.<\/p>\n\n\n\n

Turkana\u2019s recurrent outbreaks are due in part to poor healthcare infrastructure, limited awareness, malnutrition and displacement, say experts consulted by Dialogue Earth.<\/p>\n\n\n\n

Beyond Lodwar lies Loima, one of Turkana\u2019s remote sub-counties, where the rugged Loima Hills rise against the horizon. The vegetation here, shaped by a harsh, semi-arid climate, mirrors the resilience of its people. It is a landscape of determined, thorny acacia and twisting commiphora trees, scattered across the dusty plains and offering precious shade. On the slopes of the hills, the vegetation thickens slightly, with hardy bushwillows and moringa trees clinging to the rocky soil \u2013 a testament to life\u2019s endurance in a landscape often defined by drought.<\/p>\n\n\n\n

It is here that Charles Tukei, a father of 15 from Nakutan village, lost his five-year-old son to kala-azar. He says the disease is spread by people who migrate. The WHO states<\/a> that when non-immune people move into areas where transmission is high, epidemics of kala-azar can result. Poor awareness and delayed diagnosis further increase the risk of transmission in vulnerable communities.<\/p>\n\n\n\n

\"cluster<\/div>
Charles Tukei and his family live in the village of Nakutan in a sub-county of Turkana that borders Uganda (Image: Scovian Lillian)<\/div><\/div><\/div><\/div>\n\n\n\n

\u201cThis disease is dangerous,\u201d Tukei says. \u201cMost of the people here don\u2019t know it very well. It begins like malaria, and when my son caught it, I thought it was malaria. I gave him over-the-counter medication, but he did not get better.\u201d Tukei then took him to the Lodwar County Referral Hospital, but by the time they arrived, the disease had advanced. \u201cThe doctor tried to resuscitate him, but he died from spleen complications after two hospital visits.\u201d<\/p>\n\n\n\n

Kennedy Wasilwa, a clinical officer and kala-azar coordinator at the hospital, tells Dialogue Earth: \u201cWe are trying our best to treat all the patients.<\/a> Advanced-stage cases mostly present fevers associated with the enlarged spleen. And also, most of them [exhibit] bleeding, weight loss, loss of appetite, and severe abdominal pains among other symptoms.\u201d<\/p>\n\n\n\n

Around Tukei\u2019s village, deforestation is evident where trees have been cut down for firewood and trade. Sand, an obvious habitat for sandfly, is abundant.<\/p>\n\n\n\n

\u201cIn Turkana, environmental justice is closely tied to the fight against neglected diseases like kala-azar,\u201d says Wasilwa. \u201cThe changing climate, with its escalating temperatures and deforestation, exacerbates the spread of diseases, while the region\u2019s underdeveloped healthcare system only magnifies the crisis.\u201d<\/p>\n\n\n\n

In Nairobi, Cherinet Adera is a senior market access manager and researcher at the East Africa office of the Drugs for Neglected Diseases initiative (DNDi). He explains that sandflies can thrive in humid, lowland areas with high temperatures.<\/p>\n\n\n\n

Consistent rainfall would ordinarily suppress their density, because sandfly usually breed in the cracks of dry earth where moisture collects, he says. But \u201cif there\u2019s a drought, or if there\u2019s a temperature rise, sandfly density increases, meaning the risk of transmission is higher, especially if there are untreated leishmaniasis patients in the community.

\u201cDeforestation, often followed by urbanisation, brings people closer to sandfly habitats, increasing the risk,\u201d he adds.<\/p>\n\n\n\n

Adera said the WHO is about to recommend a new two-week treatment regime, down from 17 days, to reduce time spent in hospitals. The new regime includes a daily combination of an intramuscular injection and an oral drug.<\/p>\n\n\n\n

Kala-azar continues to be a major health problem in East Africa, North Africa, the Americas, and West and Southeast Asia, according to a 2023 WHO update<\/a>. In that year, 73% of reported cases came from East Africa. While four countries \u2013 Kenya, Ethiopia, Sudan and Brazil \u2013 together represented 60% of global cases.<\/p>\n\n\n\n

Samuel Kariuki, director of East Africa at DNDi, notes that robust climate data, aligned with changes in vector density, can help predict the future spread of kala-azar.<\/p>\n\n\n\n

\u201cClimate change … creates warmer ecosystems that allow sandflies to thrive and multiply. Deforestation disrupts their natural habitats, forcing the parasites to spread to new, more conducive ecosystems, including human habitats,\u201d Kariuki says.<\/p>\n\n\n\n

\u201cWhen both climate change and deforestation occur simultaneously, they pose a dual risk to the survival and spread of these vectors.\u201d<\/p>\n\n\n\n

Kariuki emphasises the need for collaboration between environmental scientists, public health experts and climate change policymakers. Together they can address the root causes of leishmaniasis and other neglected tropical diseases, he says.<\/p>\n\n\n\n

Policy advocacy must be grounded in robust data from field observations and analyses to make a convincing case for meaningful interventions, he adds.<\/p>\n\n\n\n

\u201cWe must create people-centered interventions that reflect the cultural sensitivities of affected communities. New tools, such as medicines, vaccines and vector-control methods, must be acceptable to these populations, who should be involved in all stages of developing interventions. This approach will ensure long-term ownership and sustainability.\u201d<\/p>\n\n\n\n

Adera says creating awareness is key to stopping transmission. Health strategies from various partners, including Kenya\u2019s Ministry of Health, the WHO and the DNDi can strengthen the fight against kala-azar.<\/p>\n\n\n\n

<\/div>
Recommended<\/span><\/span><\/div><\/a>\n\n\n\n

\u201cThe community must be actively engaged,\u201d he explains. \u201cThe success of kala-azar elimination, as seen in Bangladesh<\/a>, shows that concerted efforts and government commitment can reduce the disease burden.\u201d<\/p>\n\n\n\n

Countries including Kenya, Uganda, Sudan, South Sudan, Ethiopia, Djibouti and Eritrea are committed<\/a> to eliminating kala-azar in East Africa. Adera says the goal is to reduce the case fatality rate to less than 1%, and to decrease the disease\u2019s prevalence by 90% over the next 12-13 years.<\/p>\n\n\n\n

Kariuki lays out his vision: \u201cBy strengthening healthcare infrastructure, promoting sustainable environmental practices, and empowering local communities with education and resources, we can mitigate the effects of climate change and prevent the spread of diseases like kala-azar, ensuring long-term health and environmental justice.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

In Turkana county, erratic weather is driving a surge in neglected diseases, deepening health disparities for the most marginalised Kenyans<\/p>\n","protected":false},"author":50000693,"featured_media":60068638,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[761],"tags":[519,543,551],"hashtags":[],"country":[50040759],"class_list":["post-60068603","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-climate","tag-climate-impacts","tag-extreme-weather","tag-health","country-kenya"],"acf":[],"yoast_head":"\nClimate change is fuelling leishmaniasis in northern Kenya | Dialogue Earth<\/title>\n<meta name=\"description\" content=\"In Turkana county, erratic weather is driving a surge in neglected diseases, deepening health disparities for the most marginalised Kenyans\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, 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