Strengthening of clinical infrastructure for the management of Kala-azar disease in Chemolingot Hospital, East Pokot, Baringo, Kenya

This is a project to fight visceral lesimaniasis or Kala-azar in the Baringo region, Kenya. The objectives of the project are: 1. training of health workers and 2. Acquisition of medical supplies to support diagnosis and treatment and IEC materials for prevention measures.

CONTEXT

Visceral Leishmaniasis (LV), commonly known as Kala-azar, is the most serious form of leishmaniasis, posing a major health challenge. It is a silent killer, which invariably kills almost all untreated patients within 2 years, with a recurrence prevalence of approximately 20% of all cases treated in Kenya. LV is a disease of the rural, poor and marginalized population, especially boys and girls who, in most cases, also suffer from malnutrition and other infectious diseases.The Project is located in East Pokot, one of six Baringo sub-counties, Kenya, where LV is endemic. It is a remote and semi-arid area with an estimated Pokot ethnic population of 150,000 people. Key factors associated with the East Pokot community's predisposition to leishmaniasis are:

• inaccessibility to functioning health services (the average distance can reach 40 km without motorized transport),

• comorbidities of other diseases, mainly malaria, trachoma and soil-transmitted helminths (STH) (intestinal worms) and

• lack of adequate knowledge about disease transmission due to low levels of education.

PROJECT

The diagnosis of LV is made by clinical examination and parasitological or serological tests. The focus of LV treatment is case shock management with a 17- or 30-day injection protocol in the hospital, and a functional health system is required for this.

The main objective of the project is to support case management through early diagnosis and patient management at the only hospital in East Pokot, Chemolingot Sub-County Hospital. This will be accomplished through

1) Capacity building in a variety of health workers (doctors, nurses, laboratory technicians, pharmacists, registry officials, and community health promoters) in the Hospital, satellite health facilities, and the community.

2) Acquisition of medical supplies to support diagnosis and treatment and IEC materials for prevention measures.

Throughout the project, work will be done to train health personnel employed by the government who already work in the hospital to be able to provide LV services within the existing hospital system. The same Hospital Standard Operating Procedures (SOPs) that are listed in the 2017 National Guidelines for classification, diagnosis, and treatment will be followed. Medical supplies will support these services and once the project ends, the hospital will continue to operate as before as no parallel activities or programs have been introduced. In addition, community health volunteers will receive training to organize health education forums in the community. The training will cover the recognition of patients with Kala-azar, disease prevention, referral procedures for suspected cases, and record keeping.

BENEFICIARIES

About 13,300 Kalaazar patients.

Access to specialized health services for 130,000 people in the área.