Visceral leishmaniasis outbreak adds to returnees’ woes

The influx of returnees from the north to Southern Sudan ahead of an independence referendum scheduled for 9 January 2011 is raising fears of a more widespread outbreak of visceral leishmaniasis, a disease which can be lethal and is endemic in parts of the greater Upper Nile region, says a World Health Organization (WHO) official in Southern Sudan.



Leishmaniasis comes in several forms and usually manifests itself in skin sores. Visceral leishmaniasis, a severe form of the disease in which parasites have migrated to the vital organs, is also known as kala-azar.



“The returnees may negatively impact the ongoing kala-azar outbreak… as they don’t have immunity. This may exacerbate the outbreak and extend the duration,” Abdinasir Abubakar, a medical officer with the WHO communicable disease surveillance and response team in Southern Sudan, told IRIN.



At least 95,000 southerners have returned from northern Sudan since October - and thousands more are expected before the referendum and in the following months.



The ongoing visceral leishmaniasis outbreak, which was first reported in September 2009, has especially affected remote and insecure parts of Jonglei and Upper Nile states, said Abubakar. By the end of November, some 9,885 new cases with 384 deaths had been reported from 17 treatment centres in four states, with most cases being children under 17. Some 6,363 cases and 303 deaths had been reported by early October.



Displacement and malnutrition due to insecurity and failed harvests, as well as flooding, are among factors fuelling the disease. Despite an improved food security situation compared to 2009, there are fears the gains could be reversed by a huge returnee arrival in a short space of time, says the UN Office for the Coordination of Humanitarian Affairs.



The Ministry of Health and partners are working to extend the reach of treatment services. The delivery of medical supplies to areas such as Old Fangak (Jonglei State) remains challenging, with the only means of access being either by boat or plane, added Abubakar.



New cases of visceral leishmaniasis doubled in August, September and October 2010 compared to the same period in 2009. Of the new cases, 70 percent were recorded in treatment centres in Ayod, Old Fangak and Khorfulus counties in Jonglei State.



Visceral leishmaniasis is transmitted by the bite of an infected female sand fly. The vector thrives in the cracks and crevices of mud-plastered houses, cow dung heaps, rat burrows and bushes. A person with the disease suffers from lowered immunity. Left untreated it can kill.



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 IRIN film on Kala-azar