Fatal disease in Marsabit identified as severe malaria

Marsabit Malaria

A sign near Acher's Post in Isiolo County shows the distance to Marsabit and Moyale. A strange illness has ravaged Kargi location in Marsabit County.

Photo credit: File I Nation Media Group

A team of medical experts has confirmed an outbreak of a fatal disease in Marsabit County as malaria.

The experts from Marsabit County, in collaboration with specialists from the national government, confirmed the outbreak in Kargi location, where 10 people died.

This came two days after a joint team of Kenya Medical Research Institute (Kemri), the Ministry of Health, and field epidemiology specialists were dispatched to the area to reinforce the county medical team and to provide urgent mitigation measures.

Speaking to the media at the county headquarters on Monday after a brief meeting with the Kemri officials, Marsabit County Director of Public Health Boru Ali announced the dispatch of surveillance coordinators, laboratory technicians, and medical officers to Kargi Health Centre.

“Given the data we have so far, we can ascertain that it is severe malaria our populace is dealing with,” Dr Ali said.

They were joined by experts from Kemri, a disease surveillance team from the Ministry of Health and the Kenya Field Epidemiology and Laboratory Training Programme.

Out of the 101 patients screened, 35 tested positive for severe malaria. The 35 tests involved 22 rapid diagnosis tests and 13 microscopies.

Dr Ali maintained that only one death occurred at Kargi health centre and said one patient who had earlier visited the health facility later defaulted on treatment and resorted to herbal remedies.

The team of medical experts later visited villages where they established that there were nine community deaths.

Out of the nine deaths, five exhibited classic symptoms of severe malaria such as high fever, severe headaches, and body pains. The five cases were strongly related to fatal malaria, while the other four were unrelated, since one patient died after stopping TB treatment, the second was a severe childhood dehydration and the two other died of old age.

The county public health director explained that there was no intelligible interplay between the current severe malaria outbreak and the recent detection of the lethal malaria-causing mosquito species done by Kemri in Marsabit in December 2022.

Preliminary research

He said the preliminary research indicated that the current severe malaria outbreak was linked to Plasmodium falciparum, a unicellular protozoan parasite which causes malaria in human beings.

The parasite is transmitted through the female anopheles mosquito as its host, which causes malaria.

He explained that experts were yet to ascertain whether the recently detected Anopheles stephensi mosquito in Saku and Laisamis sub-counties had anything to do with the reported deaths, saying that they were yet to obtain the outcome of the research undertaken by Kemri on the lethal mosquito species.

Dr Ali advised the residents to rush to hospital in case they exhibit any symptoms of malaria, saying the disease was treatable in all the public health facilities in the county.

He assured the residents that the county and national government experts and other humanitarian agencies were on top of the situation and were working tirelessly to avert any further deaths.

The team on the ground was busy with active case searches, sample collections, referrals of serious cases, distribution of insecticide-treated nets to the affected areas and mass awareness to the residents on the treatability of the disease, he added.

Marsabit County Health Executive Grace Galmo said the devolved unit could authoritatively establish from the findings they had that there was a fatal or severe malaria outbreak in the region.

She, however, maintained that all the patients who died had travel histories out of the county to Samburu County.

She held that they succumbed majorly because they did not report to the health facilities in good time.

However, those who were lucky to report to the health facilities in the region in time survived.

She also announced that there was an outbreak of neglected zoonotic diseases (NZD) such as kala-azar in Laisamis sub-county, where eight cases had been confirmed. Three of the patients are admitted to Laisamis sub-county hospital and five others are undergoing treatment at home.

“After doing the verbal autopsy, it is very clear these are people who travelled to satellite camps and were coming back from areas of Archers Post and Sorolilipi and were unable to reach the health facilities in time,” Ms Galmo said.

Dangerous mosquito

The Kemri Entomology Research team together with colleagues from the Ministry of Health detected a new dangerous mosquito vector in Kenya on December 22, 2022.

The detection was made during routine mosquito surveillance in different counties across Kenya, where the new malaria vector known as Anopheles stephensi in Saku and Laisamis sub-counties in Marsabit County was detected and confirmed.

The Anopheles stephensi was known to occur and spread malaria in South-East Asia, the Middle East, and the Arabian Peninsula.

The mosquito species has been expanding its geographic range over the past decade, with detections being reported in Djibouti (2012), Ethiopia, Sudan (2016), Somalia (2019), and Nigeria (2020).

In 2019, a kala-azar outbreak in Laisamis sub-county, led to the deaths of at least seven people in Log Logo, Laisamis and Kargi. At least 27 Laisamis residents were hospitalised.

Kala-azar is caused by more than 20 species of parasitic protozoa of the genus Leishmania. The disease is transmitted to humans by sand flies, which mostly live in anthills and mud houses.