Control of visceral leishmaniasis in Somalia: achievements in a challenging scenario, 2013–2015

Overview

The population of Somalia have endured a complex sociopolitical environment for more than 20 years, and have been confronted with a humanitarian crisis that has forced them to face poverty, food insecurity, armed conflict and overall uncertainty. The public health system of Somalia has been largely destroyed during the ongoing civil war, and the resulting emergency situation has made access to medical care a significant challenge.

The country is endemic for visceral leishmaniasis (VL) and is regarded by WHO as one of the 14 “high-burden” coun-tries for VL. In Somalia, the disease is caused by Leishmania donovani and the vectors that potentially transmit the infection include Phlebotomus martini and P. vansomerenae. As with other VL endemic areas in the East African region, VL is considered anthroponotic in Somalia.

Since 2011, WHO, in partnership with NGOs, has been implementing a strategy to scale up activities for VL control. In 2012, national guidelines for leishmaniasis were published for the first time in Somalia. Current VL control activities include standardized screening, diagnostic testing, treatment and surveillance.

This report describes the epidemiological and clinical features of VL cases presented to the 3 VL treatment centres in Somalia: Huddur and Tieglow in the Bakool region and Baidoa in the Bay region. Individual patient data that had been routinely collected between January 2013 and December 2015 was used.