Disclosed: The Deadliest Diseases Behind Outbreaks in Kenya.

A recent surveillance report from the Ministry of Health reveals that six counties account for a quarter of all disease outbreaks reported in Kenya over the past 15 years. The report indicates that the nation is experiencing an increasing number of outbreaks annually.

In 2012, only one county reported an outbreak, but by 2022, all 47 counties had documented outbreaks, primarily due to Covid-19. This analysis, which spans from 2007 to 2022, was published on October 15 in the BMC Research Notes journal.

The counties of Garissa, Nairobi, Nakuru, Wajir, Mandera, and Mombasa contributed to 25% of the 457 outbreaks reported during this period. The average number of outbreaks per county was four, with Nairobi recording the highest number of cases and deaths, accounting for approximately one-third of cases and a quarter of deaths. Conversely, Samburu reported the fewest cases.

Factors such as population density, proximity to international borders, and access to healthcare services have been identified as contributors to these disparities.

The report’s authors—Farida Geteri and Samuel Kadivane from the Disease Surveillance and Response Unit at the Ministry of Health, alongside Emmanuel Okunga, Jeanette Dawa from the University of Nairobi, John Gachohi from Washington State University, and Felix Humwa from the Africa Society for Laboratory Science in Addis Ababa—highlight that 23 diseases were responsible for the outbreaks. Covid-19, cholera, malaria, kala-azar, and measles represented a significant disease burden, leading to a total of 6,575 reported deaths.

Surveillance in Kenya follows the Integrated Disease Surveillance and Response strategy, adapted from the World Health Organization. This strategy facilitates the collection of health data for multiple diseases and public health events, which is then uploaded to the Kenya Health Information System.

The authors summarized archived data from 2007 to 2022 on the annual incidence of diseases, outbreak reports, case counts, and deaths per outbreak across all counties. They define a disease outbreak as the occurrence of any priority disease within a county during a specific year.

Geteri noted that HIV is no longer classified as an outbreak in Kenya, citing a consistent decline in new infections and AIDS-related deaths due to effective intervention strategies, which have transformed HIV into a more manageable public health issue.

The researchers suggest that the increasing number of reported outbreaks may reflect enhanced surveillance capabilities rather than a rise in disease occurrences. This analysis has been commended for contributing to a body of literature on outbreak occurrences that is more accessible to researchers, as such information is often limited to country-level surveillance reports.

The 23 diseases identified include acute flaccid paralysis, aflatoxicosis, anthrax, chikungunya, cholera, Covid-19, dengue fever, influenza A, kala-azar, malaria, measles, mumps, pertussis, Q-fever, rabies, Rift Valley fever, SARI, schistosomiasis, typhoid fever, viral hepatitis, and yellow fever.

Officials emphasize the need to strengthen immunization programs in light of the prevalence of vaccine-preventable diseases and underscore the importance of establishing an early warning and response system to manage outbreaks effectively. In 2015, anthrax, rabies, and Rift Valley fever were identified as the most significant zoonotic threats facing Kenya.

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