Kala azar is spread by the bite of sand flies, and is considered a serious neglected tropical disease. If the patient is left untreated, the mortality rate may reach 95%. The disease causes symptoms such as fever, weight loss, and enlargement of the spleen and liver.

## Kala azar in Kenya

Kenya has seen a significant rise in cases of kala azar, also known as visceral leishmaniasis. According to the Ministry of Health, the number of cases increased from 1,575 in 2024 to 3,577 in 2025.

The disease spreads to new areas where it has not previously appeared, and becomes endemic there. Health officials attribute this to changing climate conditions and urban expansion, which makes millions vulnerable to infection.

The World Health Organization estimates that East Africa accounts for more than two-thirds of globally recorded cases.

“Climate change is expanding the range of sand flies and increasing the risk of disease outbreaks in new areas,” says Dr. Shirinit Adera, a researcher at the Medicines for Neglected Diseases Initiative in Nairobi.

## Growing anxiety

A sharp rise in infections among migrant workers at a quarry site in Mandera last year prompted restrictions on movement at dusk and dawn, periods when sand flies are most active.

Fellow workers reported that at least two of them had died, while others returned to their villages, their fate remaining unknown.

“We knew nothing about this strange disease that killed our colleagues,” says Evans Omondi, 34, who traveled hundreds of miles from western Kenya to work in the quarry.

But Dr. Paul Kibati, a tropical diseases expert at the NGO Amref Health, told AFP that “the number of health facilities capable of diagnosing and treating visceral leishmaniasis in the country is very small.”

He adds that there is an urgent need for more training, because errors in diagnosis and treatment could be fatal.

Kibati explained that:

* Treatment can last up to 30 days, involves daily injections and often blood transfusions, and costs up to 100,000 Kenyan shillings (US$775), excluding the cost of medications.
* Due to the need to “adequately equip health facilities.”

Sand flies usually hide in the cracks of poorly painted mud houses, in ant hills, and in soil cracks, and breed in abundance during the rainy season after long periods of drought.

Northeastern Kenya, as well as neighboring regions of Ethiopia and Somalia, have experienced catastrophic drought in recent months.

“Visceral leishmaniasis (kala azar) mainly affects the poorest segments of our society,” says Kibati, and this disease is exacerbated by malnutrition and weak immunity.

Kibati adds: “We expect cases to increase with the start of the rainy season.”