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| Neglected killer Kala-azar disease surges in Kenya.Photo/Coutersy |
For nearly a year, repeated misdiagnosis of a deadly parasitic disease caused the health of 60-year-old Harada Hussein Abdirahman to steadily worsen, reflecting a broader and alarming surge of kala-azar cases in Kenya’s arid regions. Kala-azar, medically known as visceral leishmaniasis, is transmitted through sandfly bites and is one of the most dangerous neglected tropical diseases. If untreated, it can be fatal in up to 95 percent of cases.
The disease causes prolonged fever, severe weight loss, and swelling of internal organs such as the liver and spleen. According to Kenya’s Ministry of Health, reported kala-azar cases rose sharply from 1,575 in 2024 to 3,577 in 2025, more than doubling within a year. Health officials say the disease is spreading into new areas and becoming endemic in parts of the country, placing millions at risk.
Abdirahman, a grandmother from the hilly rural areas of Mandera County, believes she was bitten by a sandfly while herding livestock in a region known to be a hotspot for kala-azar. With only three health facilities in the wider region capable of diagnosing and treating the disease, she first sought help from a local pharmacist. For almost a year, her illness was repeatedly misdiagnosed as malaria and dengue fever.
“I thought I was dying,” she said, explaining that her condition continued to deteriorate despite treatment. She later developed hearing problems after undergoing intensive medical procedures aimed at removing toxins from her body once the correct diagnosis was finally made.
According to the World Health Organization, East Africa accounts for more than two-thirds of global kala-azar cases. Experts warn that climate change is expanding the habitat of sandflies, increasing the risk of outbreaks in areas that were previously unaffected. Dr. Cherinet Adera, a researcher with the Drugs for Neglected Diseases Initiative in Nairobi, said changing weather patterns combined with expanding human settlements have played a key role in the recent increase in cases.
In Mandera, a spike in infections last year among migrant quarry workers prompted authorities to restrict movement during dusk and dawn, when sandflies are most active. Workers reported that at least two colleagues died, while others returned to their home regions with outcomes that remain unknown.
“We did not know about the strange disease that was killing our colleagues,” said Evans Omondi, a 34-year-old labourer from western Kenya. Another worker, Peter Otieno, said they watched infected colleagues lose weight rapidly before dying.
In 2023, six African countries most affected by kala-azar adopted a regional framework in Nairobi aimed at eliminating the disease by 2030. However, Dr. Paul Kibati, a tropical disease expert with health NGO AMREF, said Kenya still has very few facilities capable of accurately diagnosing and treating kala-azar. He warned that diagnostic and treatment errors can be fatal and stressed the need for better training of health workers.
Treatment for kala-azar can take up to 30 days and often involves daily injections and, in some cases, blood transfusions. While the drugs are provided free, the overall cost of care can reach up to 100,000 shillings, making access difficult for poor communities.
Sandflies usually breed in cracks of mud houses, soil fissures, and anthills. Their populations increase after rainy seasons that follow prolonged droughts, conditions recently experienced in northeastern Kenya and neighbouring Ethiopia and Somalia. Dr. Kibati warned that the disease disproportionately affects the poorest and most malnourished populations and said more cases are expected when the rains begin.
