Kala azar outbreak in Ethiopia as rainy season begins

Kala azar, or visceral leishmaniasis, is transmitted by the sandfly. It is estimated that 500,000 new cases appear every year in the world. After two to six months of incubation, the parasite attacks the defense system of the infected person. The disease is characterized by high fever, swelling of the spleen and important weight loss. If not treated, the sick will die in a few months.

It was due to the insistence of an MSF team working in the region that the disease -unknown in this area- was diagnosed.

With the problem identified, MSF has taken the lead in the response. The district health center was reorganized to accomodate the numerous sick persons. Today, close to 100 patients are treated here and approximately the same number are receiving treatment in the community.

“Most of the persons that we have been treating had a life expectation of not more than three months”, said Yanos Orfanos, an MSF medical doctor. Although new cases still appear, it is hoped that the outbreak will decrease with the rainy season that has just begun.

First cases

The first suspect deaths occurred last fall and their number slowly increased. In the peak of the epidemic, two to three persons were dying every day, according to community leaders.

At first, local health authorities thought it was a malaria outbreak and treated the patients accordingly. But when the treatment showed no results, the MSF team insisted that further tests should be performed. Although this region was not known as a kala azar endemic area, they thought it could be the cause of so many deaths. The doctor’s suspicion was finally confirmed with laboratory tests in early May.

The authorities and health infrastructure of the region were not prepared to face such an outbreak. To assist, MSF has set up a kala azar treatment unit in the neighboring Addis Zemen health center. Five tents, each one with capacity for 12 patients, have been installed in the health centre compound.

Due to the high number of patients, two wards and a corridor of the center, originally designed for 10 inpatients, have also been occupied.

On admission,many patients are severely malnourished so, beside the kala azar medication – a daily injection for one month - most patients need nutritional treatment as well. Other conditions caused by the kala azar infection – such as pneumonia or anemia - also need to be treated.

As soon as the patients’ condition improves, they are discharged. Then, a medical team will visit them in the community to give them an injection every day until the month long treatment is complete.

The measures adopted to fight the epidemic are working.

Most of the patients that are treated in Addis Zemen improve rapidly. More than 100 of them have already been discharged, and up to now, only three patients admitted in the center have died: an elder who refused to take the medication and two children that were very severely malnourished on admission.