Ouma Francan F, Mulambalah Chrispinus S
Masinde Muliro University of Science & Technology, Department of Biological Sciences, P. O. Box 190 50100 Kakamega, Kenya.
Moi University, School of Medicine, Department of Medical Microbiology & Parasitology, P. O. Box 4606, Eldoret, Kenya.
J Parasitol Res. 2021 Oct 18;2021:9989581. doi: 10.1155/2021/9989581. eCollection 2021.
BACKGROUND: Leishmaniases present a major global public health problem, being responsible for between 40,000 and 50,000 deaths annually. The resultant morbidity affects the economic productivity and quality of life of individuals in endemic regions. As zoonotic disease(s), leishmaniases have become persistent with intermittent transmission and a tendency to disappear and reemerge, straining the fragile healthcare infrastructure in Kenya. There is a need to better understand disease(s) dynamics in Kenya. . The status of leishmaniases in Kenya was reviewed to refocus and influence the attention of the scientific community and intervention strategies/policies on this persistent public health problem. . Electronic and manual literature were searched for relevant scholarly peer-reviewed published articles on leishmaniases. Literatures were obtained from PubMed, Medline, EBSCO, Host, ScienceDirect, and Google Scholar. . The diseases are reported to be persistent as emerging and reemerging within and outside traditional endemic regions. Cutaneous leishmaniasis (CL) has maintained restricted foci in Nyandarua, Baringo, Nakuru counties, and Mount Elgon area in Bungoma County. Visceral leishmaniasis (VL) was most prevalent with cases in Baringo, Turkana, West Pokot, Isiolo, Kitui, Meru, Machakos, Marsabit, and Wajir counties. New VL cases/foci reported in formerly nonendemic regions/beyond traditional foci of Garissa and Mandera counties. Diagnostics, management, and control strategies have remained unchanged even in the face of changing disease epidemiology. CONCLUSION: Leishmaniases are emerging and reemerging persistent infections in remote rural settings in Kenya. The adopted intervention strategies have not been effective over the years, and this has led to disease spread to formerly nonendemic areas of Kenya. The diseases spread have been further enhanced by population growth and movement, environmental and climate changes, and social conflicts. It is evident that without a paradigm shift in control methods, diagnostic techniques, and treatment protocols, the diseases may spread to even more areas in the country.
背景：利什曼病是一个重大的全球公共卫生问题，每年导致4万至5万人死亡。由此产生的发病率影响着流行地区个人的经济生产力和生活质量。作为人畜共患病，利什曼病一直存在，传播断断续续，有消失和重新出现的趋势，给肯尼亚脆弱的医疗基础设施带来压力。有必要更好地了解肯尼亚的疾病动态。对肯尼亚利什曼病的现状进行了综述，以重新聚焦并影响科学界的关注以及针对这一持续存在的公共卫生问题的干预策略/政策。通过电子和人工检索，查找了有关利什曼病的相关学术同行评审发表文章。文献来自PubMed、Medline、EBSCO、Host、ScienceDirect和谷歌学术。据报道，这些疾病在传统流行地区内外持续以新出现和重新出现的形式存在。皮肤利什曼病（CL）在尼亚丹鲁瓦、巴林戈、纳库鲁县以及布贡马县的埃尔贡山地区保持着有限的疫源地。内脏利什曼病（VL）最为普遍，在巴林戈、图尔卡纳、西波科特、伊索洛、基图伊、梅鲁、马查科斯、马萨比特和瓦吉尔县均有病例。在加里萨和曼德拉县以前的非流行地区/传统疫源地之外报告了新的VL病例/疫源地。即使面对不断变化的疾病流行病学，诊断、管理和控制策略仍未改变。 结论：利什曼病在肯尼亚偏远农村地区不断出现并重新成为持续性感染。多年来所采用的干预策略一直无效，这导致疾病传播到肯尼亚以前的非流行地区。人口增长和流动、环境和气候变化以及社会冲突进一步加剧了疾病的传播。显然，如果在控制方法、诊断技术和治疗方案上不发生范式转变，这些疾病可能会在该国传播到更多地区。
J Parasitol Res. 2021-10-18
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