Tweet
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 26: 21-27 June 2021
Data as reported by: 17:00; 27 June 2021
...
Visceral Leishmaniasis Chad
122 Cases
6 Deaths
4.9% CFR
EVENT DESCRIPTION
Visceral leishmaniasis (VL), also known as kala-azar or black
fever, is the most serious form of leishmaniasis. It is a disease
caused by a parasite of the genus Leishmania. Among parasites,
it is the second biggest killer in the world after malaria. Each
(Plasmodium and Leishmania) is responsible for an estimated
half a million deaths worldwide each year. Cases of VL were first
reported in Chad in 1966, while the cutaneous and mucocutaneous
forms were diagnosed in 1968. Similar cases have also been
confirmed in the neighbouring countries of Western Africa.
Visceral leishmaniasis often occurs in N’Djamena and Lake Chad
areas, extending eastward throughout southern Chad. Cutaneous
leishmaniasis occurs in Chari-Baguirmi Prefecture (includes
N’Djamena), along the Chari River in south central Chad, and in
the northern and northeastern sub-desert and desert areas. Peak
transmission has been known to occur from April to November.
Sporadic cases of leishmaniasis have been reported in Chad
since 2018. In August 2020, health authorities in Chad received
rumours of a febrile illness among young gold miners in the
provinces of Tibesti and Borkou (desert regions of northern
Chad). Consequently, an investigative team was deployed to the
affected areas and identified a total of 68 suspected cases with
two deaths in the health registers and medical files. Following
the recommendations of this mission, and with technical support
from key partners, 19 blood samples were sent to the Parasitology
Reference and Research Laboratory (Carlos III Health Institute) in
Madrid, Spain for confirmation and identification of the species.
Analysis of these samples found 16 positive (Kr39 antigens)
cases by rapid diagnostic tests (RDT) and 13 positive cases by
polymerase chain reaction (PCR). Leishmania donovani was
identified during preliminary analysis.
Since 1 January 2018 to 31 May 2021, a total 122 cases of VL
have been reported by three provinces of N’Djamena, Borkou and
Tibesti. Of the 122 cases, (2, 4.0%) have died, while about (98,
80.0%) have recovered. Case-patients identified in N’Djamena’s
are from Miski’s and were all self-referrals. The health districts
reporting the highest number of cases are Bardai, which
accounted for 4 950 (50.0%) of reported cases, followed by
Zouar (30; 25.0%), Faya with (1, 1.0%) and 20 cases (16.4%)
from unknown areas.
Most cases (60; 71.0%) have been reported in the age group of
<5 years, followed by those 16 years and older (23;19.0%). More
men have been affected (60%) than women (40%).
PUBLIC HEALTH ACTIONS
The National Coordination team including the Ministry of
Public Health National Solidarity and partners) has been
put in place for this outbreak, and a response plan has been
finalised.
A joint mission between the Ministry of Public Health and
National Solidarity, and partners visited Faya (Borkou) and
Bardaï (Tibesti) from March 19 to April 2, 2021 to strengthen
the capacity of health workers in two provinces on the
management of VL in accordance with the WHO protocol.
Laboratory technicians were trained on the use of Rapid
Diagnostic Tests (Ag Kr39).
A laboratory system was put in place to collect samples
from all suspected cases. A total of 19 blood samples were
collected and sent to the WHO collaborating Center in Spain
for confirmation.
The provincial hospitals of Faya and Bardai have been
provided with drugs for the management of cases, and rapid
diagnostic tests.
Surveillance has been strengthened, all suspected cases
are tested, active case finding is conducted in healthcare
facilities, and a data collection system has been put in place.
SITUATION INTERPRETATION
Visceral Leishmaniasis is endemic in some areas of Chad.
However, currently, the incidence and prevalence rates of the
disease are not known in the country. The current increase of
cases draws much attention, and appropriate public health
actions have been undertaken.
The establishment of a national coordination team, a response
plan, and the strengthening of the surveillance system will help
to fight this infection which has been neglected for many years
https://apps.who.int/iris/bitstream/...2127062021.pdf