In the last stages, patients would slip into a deep, irreversible sleep, one from which dozens of Kenyans never woke up. Photo/ WHO.
It was known as the “silent killer”
of the countryside. Victims would start with a fever, then headaches, then
confusion. They would eventually slip into a deep, irreversible sleep, one from
which dozens of Kenyans never woke up.
That nightmare is now officially
over.
The World Health Organization (WHO)
has validated Kenya as having eliminated human African trypanosomiasis – commonly
known as sleeping sickness – as a public health problem. The announcement, made
on Thursday, marks a historic milestone in the country’s long battle against
the deadly disease.
“I congratulate the government and
people of Kenya on this landmark achievement,” said Dr Tedros Adhanom
Ghebreyesus, WHO Director-General. “Kenya joins the growing ranks of countries
freeing their populations of human African trypanosomiasis. This is another
step towards making Africa free of neglected tropical diseases.”
According to the WHO, eliminating a
disease as a public health concern does not mean the disease is completely gone
(eradicated). A few cases may still occur, but they are rare, well monitored, quickly
detected and treated. That means the disease is under control and no longer
causing widespread illness or deaths.
Sleeping sickness is caused by a
parasite transmitted through the bite of an infected tsetse fly. The disease
affects mainly rural populations, especially those involved in agriculture,
animal husbandry, hunting, or fishing.
The fight against sleeping sickness
in Kenya began in the early 20th century when the first cases were identified.
The disease was a major cause of
illness and death, particularly in areas with high wildlife and livestock
interaction. The Maasai Mara, for instance, was a known hotspot. The last
locally acquired case in Kenya was reported in 2009, and the last two exported
cases, infected in Masai Mara, were reported in 2012.
Although exact figures are hard to
trace, historical records and WHO reports suggest sleeping sickness killed
thousands across East Africa over the decades, often going undiagnosed or
misdiagnosed until it was too late.
In Kenya, the form of the disease
present is the faster-progressing r-HAT (rhodesiense human African
trypanosomiasis), which can cause death within weeks if untreated. It attacks
multiple organs and invades the brain, leading to severe neurological symptoms
and coma.
Symptoms begin with fever,
headaches, muscle and joint pain. As the disease advances, it affects the
central nervous system, causing confusion, poor coordination, personality
changes, and severe sleep disturbances. In its final stage, it results in coma
and death.
There is no vaccine and prevention
relies heavily on early detection, treatment, tsetse fly control, and
surveillance.
“This validation marks a major public health
milestone for Kenya, as we celebrate the elimination of a deadly disease in our
country,” said Dr Aden Duale, Health CS, according to a statement from the WHO.
“The achievement will not only protect our people but also pave the way for
renewed economic growth and prosperity. This follows many years of dedication,
hard work and collaboration.”
Kenya strengthened surveillance in
12 health facilities spread across six historically endemic counties. These
facilities were equipped with diagnostic tools and their personnel trained to
detect the disease using the most practical and sensitive tests available.
The country also enhanced vector
surveillance and control efforts, particularly through the Kenya Tsetse and Trypanosomiasis
Eradication Council (KENTTEC). National veterinary authorities monitored animal
trypanosomiasis, which also plays a role in human infections.
“This key milestone reflects Kenya’s
efforts and commitment over many years, as a collaboration between national and
county governments, national research institutions, development partners and
affected communities,” said Dr Patrick Amoth, the Director General for Health.
“The country remains fully committed to sustain the quality of care and
surveillance in line with WHO’s recommendations.”
Kenya is now the tenth country to be
certified by WHO as having eliminated sleeping sickness as a public health
problem. The others are Benin, Chad, Côte d’Ivoire, Equatorial Guinea, Ghana,
Guinea, Rwanda, Togo and Uganda.
This also marks Kenya’s second
success in tackling neglected tropical diseases (NTDs), having been certified
free of Guinea worm disease in 2018.
Globally, 57 countries have now
eliminated at least one NTD. These milestones are key steps towards achieving
the WHO roadmap for NTDs, which targets the elimination of multiple diseases by
2030.
Experts warn that the work is not
over despite the success.
“This success was made possible by
the Ministry of Health’s leadership, the dedication of health workers in areas
at risk and the support from key partners,” said Dr Abdourahmane Diallo, WHO
Representative to Kenya. “WHO is proud to have contributed to this achievement
and encourages all stakeholders to remain involved in post-validation
monitoring.”
Kenya will now implement a
post-validation surveillance plan to ensure early detection of any new cases.
This includes continuous monitoring in areas like Maasai Mara, where tsetse fly
populations and wildlife reservoirs still pose a risk of reintroduction.
WHO has committed to support this
next phase and will maintain a stockpile of medicines for rapid deployment in
case of any new outbreaks.