Department of Medical Microbiology and Infection Prevention, Laboratory for Experimental Parasitology, Amsterdam University Medical Centre, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands.
Amsterdam Institute for Immunology and Infectious Diseases, Infectious Diseases Programme, Amsterdam, The Netherlands.
BMC Infect Dis. 2024 Oct 16;24(1):1169. doi: 10.1186/s12879-024-10053-4.
Visceral leishmaniasis (VL) remains a significant public health concern in West Pokot County, Kenya, where a large outbreak between 2020 and 2022 emphasised the need for improved VL control strategies. However, these measures are partially hampered by limited insight into the geographical distribution of cases and localised outbreaks of the disease. This study aimed to describe the epidemiology and spatiotemporal patterns of VL in West Pokot between 2018 and 2022, in order to map the spread of VL transmission and identify regions that should be prioritised for control interventions.
VL patient demographics and village of residence were retrieved from admission records of Kacheliba Sub-County Hospital in West Pokot, Kenya. The temporal trend in VL admissions between 2018 and 2022 was analysed using seasonal decomposition analysis. To describe the spatial distribution of VL cases, geographic coordinates of villages of residence were collected from pre-established databases, and VL incidence was mapped at the sub-location level. Hotspot analysis was performed per study year to identify villages with high VL incidence, and scan statistics were applied to detect spatiotemporal clusters of VL cases during the study period.
A total of 1948 VL patients were reported between 2018 and 2022. The annual number of cases increased from 245 in 2019 to 598 in 2022, and VL admissions were generally higher at the start of the wet seasons. 70% of the VL cases could be georeferenced, and mapping of VL incidence revealed high case rates in the east of West Pokot during the complete study period. The eastern villages Lotongot and Chepaywat were marked as VL hotspots at a 99% confidence level in all study years. In addition, five significant spatiotemporal clusters were detected in the east and north, suggestive of local VL outbreaks in these regions.
The increase in VL hospital admissions during the study period stresses the need for enhanced VL control and outbreak mitigation in West Pokot. These control measures should be focused on the hotspot regions in the east of the county.
内脏利什曼病（VL）仍然是肯尼亚西波科特县的一个重大公共卫生问题，2020 年至 2022 年期间的一次大规模疫情强调了需要改进 VL 控制策略。然而，这些措施部分受到对病例的地理分布和疾病局部暴发的了解有限的阻碍。本研究旨在描述 2018 年至 2022 年期间西波科特县的 VL 流行病学和时空模式，以便绘制 VL 传播的范围，并确定应优先进行控制干预的区域。
从肯尼亚西波科特县卡切利巴分区医院的入院记录中检索 VL 患者的人口统计学数据和居住村庄。使用季节性分解分析对 2018 年至 2022 年期间 VL 入院的时间趋势进行分析。为了描述 VL 病例的空间分布，从预先建立的数据库中收集居住村庄的地理坐标，并在分区层面上绘制 VL 发病率。对每个研究年份进行热点分析，以确定 VL 发病率较高的村庄，并应用扫描统计数据检测研究期间 VL 病例的时空聚类。
2018 年至 2022 年共报告了 1948 例 VL 患者。病例数量从 2019 年的 245 例增加到 2022 年的 598 例，VL 入院通常在湿季开始时较高。70%的 VL 病例可以进行地理定位，VL 发病率的绘制显示，在整个研究期间，西波科特的东部村庄洛通戈特和切帕沃特的发病率较高。在所有研究年份中，东部村庄洛通戈特和切帕沃特均被标记为 VL 热点，置信水平为 99%。此外，在东部和北部检测到五个有意义的时空聚类，表明这些地区存在局部 VL 暴发。
在研究期间，VL 住院人数的增加强调了需要在西波科特加强 VL 控制和暴发缓解。这些控制措施应集中在该县东部的热点地区。
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