Neglected Killer Disease Kala-Azar Surges in Kenya

By : Mweru Mbugua 

Cases of the deadly kala-azar disease are surging across Kenya’s arid and semi-arid regions, alarming health officials as the neglected tropical illness spreads into previously unaffected areas and claims a record number of lives

For nearly a year, 60-year-old Harada Hussein Abdirahman endured repeated misdiagnoses as her health steadily worsened. Living in Mandera County in northeastern Kenya, one of the country’s worst-affected regions, she was treated for malaria and dengue fever before doctors finally identified kala-azar, a parasitic disease spread by sandflies

“I thought I was dying,” Abdirahman told AFP. “It is worse than all the diseases they thought I had”

Kala-azar also known as visceral leishmaniasisis one of the world’s most dangerous neglected tropical diseases. If left untreated, it has a fatality rate of up to 95 percent and causes prolonged fever, severe weight loss, and enlargement of the spleen and liver

According to Kenya’s Ministry of Health, reported cases more than doubled from 1,575 in 2024 to 3,577 in 2025. Health officials warn the disease is becoming endemic in new regions, driven by climate change, population movement, and expanding human settlements

“Climate change is expanding the range of sandflies and increasing the risk of outbreaks in new areas,” said Dr Cherinet Adera of the Drugs for Neglected Diseases Initiative in Nairobi

East Africa accounts for more than two-thirds of global kala-azar cases, according to the World Health Organization. In Kenya, Mandera County remains a hotspot, yet it has only three facilities capable of treating the disease

Abdirahman believes she was bitten while herding livestock near stone quarry sites outside Mandera town. Like many others in remote areas, she relied on a local pharmacist, delaying proper diagnosis and treatment. She now suffers hearing problems caused by harsh medications used during the prolonged misdiagnosis

Fear spread last year when a cluster of cases emerged among migrant workers at a quarry site in Mandera. Authorities imposed movement restrictions at dawn and dusk—when sandflies are most active—after at least two workers died. Others returned to their home villages, and their outcomes remain unknown

“We did not know about the strange disease causing our colleagues to die,” said Evans Omondi, 34, who travelled from western Kenya to work at the quarry. “We were so scared,” added fellow worker Peter Otieno, recalling how infected colleagues wasted away

In 2023, six African countries most affected by kala-azar adopted a framework in Nairobi aimed at eliminating the disease by 2030. However, experts warn that progress is hampered by limited diagnostic and treatment capacity

“There are very few facilities in the country able to actively diagnose and treat kala-azar,” said Dr Paul Kibati, a tropical disease specialist with health NGO Amref. He stressed that inadequate training can lead to fatal errors in testing and treatment

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Treatment can last up to 30 days and involves daily injections, sometimes accompanied by blood transfusions. The cost can reach 100,000 Kenyan shillings (about $775), excluding medication—an expense far beyond the reach of most affected families

Sandflies commonly breed in cracks in poorly plastered mud houses, anthills, and soil fissures, multiplying rapidly during rainy seasons that follow prolonged droughts. Northeastern Kenya, along with neighbouring parts of Ethiopia and Somalia, has recently endured severe drought, followed by conditions favourable to the insects

“Kala-azar mostly affects the poorest in our communities,” Kibati said, noting that malnutrition and weakened immunity increase vulnerability. “We are expecting more cases when the rains start”

Health officials warn that without increased investment in surveillance, diagnosis, and treatment facilities, kala-azar will continue to spread silently—killing those least able to access care