UN seeks increased funding for response to kala-azar epidemic in south Sudan

More than 6,300 cases of visceral leishmaniasis, a parasitic disease also known as kala-azar, have been recorded in southern Sudan over the past one year, the United Nations health agency reported today, saying $700,000 is required to combat the recurring outbreaks of the illness in the region.

The UN World Health Organization (WHO) said it is supporting the region’s health authorities and other health sector partners by providing and distributing medicines and laboratory diagnosis materials to five health facilities in Jonglei and Upper Nile states where those infected are being treated.

The agency is also helping train health personnel on case management, laboratory diagnosis, and conducting active case searching and surveillance. The current intervention has been supported by the Spanish Government and the European Commission's Humanitarian Aid department (ECHO).

With more than 300 people having died in the latest outbreak of kala-azar, WHO put the case fatality rate at 4.7 per cent, adding that the number of cases is more than six times higher compared to 2007 when 758 cases were recorded, and 2008 when there were 582 cases.

Some 70 per cent of the patients are children under the age of 15, already suffering from concurrent malnutrition and other secondary illnesses.

Funds are required to expand the coverage of treatment centres and buy more medicines, diagnostic kits and nutritional supplies.

Kala-azar is a neglected tropical disease endemic to southern Sudan, a region also affected by insecurity and weak health services. The spike in cases was recorded during the rainy season between May and September this year, a period when normally fewer cases are expected. The increased cases were reported particularly in Old Fangak and Ayod counties in Jonglei.

“The increased number of cases in Old Fangak, Ayod and surrounding areas is very disturbing and it is becoming difficult to contain the outbreak,” said Abdi Aden, head of WHO’s office in southern Sudan. “Before the situation becomes uncontrollable, we must do something about it,” he added.

The kala-azar outbreak could worsen between now and April next year, according to Mounir Christo Lado, the director of endemic tropical diseases control in southern Sudan’s health ministry.

“Insecurity, flooding and the lack of health facilities across a vast geographical area are all playing a part in limiting access to treatment for this deadly disease,” said Mr. Lado.

Kala-azar is transmitted by the bite of sand flies and mortality rates can be as high as 95 per cent if not treated on time. The most common symptoms include fever, weight loss, enlargement of the spleen, anaemia, diarrhoea and fatigue.

Treatment involves daily injections of sodium stibogluconate for one month and requires patients to stay near health facilities for observation. The disease suppresses the immune system, leaving victims vulnerable to other infections such as malaria or pneumonia.