Somalia experiencing huge increase in cases of visceral leishmaniasis

The international humanitarian organization Médecins Sans Frontières has witnessed a dramatic increase in the number of patients with the parasitic disease visceral leishmaniasis ("kala azar") admitted to its treatment center in Somalia.

The disease is transmitted by sand flies and causes fever, weight loss, anemia, and enlargement of the liver and spleen.

Marie-Eve Raguenaud (MSF Medical Department, Brussels, Belgium) and colleagues analyzed data on 1,671 patients with visceral leishmaniasis (VL) admitted to the Huddur health center in Bakool Region, Somalia, from January 2002 until December 2006.

In the first four years, the average number of admissions of patients with VL was stable (an average of 140 admissions per year), but this was then followed by a dramatic rise in cases presenting to the center. In 2006, there was a seven-fold increase in admissions over previous years.

The turmoil and factional fighting that followed the regime's overthrow in 1991 has left large parts of Somalia without any form of health care. Médecins Sans Frontières has been working in Huddur since 2000, running a primary health-care project consisting of outpatient and in-patient departments, a therapeutic feeding centre, and a TB and a VL program. This was the only treatment centre for VL in Bakool region until 2006.

“Our experience suggests that VL is substantially underreported in Bakool region and possibly in neighboring regions of southern Somalia,” the researchers say. “The true magnitude of the problem of VL in Somalia is likely to remain unknown and documentation and implementation of effective interventions to control VL will be limited as long as there will be no safe access to population and inexistent health care services.”