NTD Program: Use of data and modelling to inform program decision making.

 • “A healthy and productive nation free from NTDs”, is the vision of the MOH – NTD program. NTDs, a diverse group of conditions of bacterial, viral, parasitic, fungal, and noncommunicable in origin. PC- NTDs; NTDs amenable by WASH and preventive chemotherapy and contribute to the highest burden. These are Schistosomiasis, Soil transmitted helminths (STHs), Lymphatic filariasis (elephantiasis) and Trachoma. These are targeted for control and elimination by 2027. CM – NTDs; managed at the health facilities and targeted for control. These are rabies, leprosy, leishmaniasis, snakebites envenoming (SBE), scabies and ectoparasites among other.

• Morbidity for NTDs; detectable, measurable clinical consequences of infectionsand disease that adversely affect the healthof individuals. o Measured in DALY’s – Disability Adjusted Life Years; This is a measurement of the gap healthy life lost, between an “ideal” healthy population and the reality caused by a specific disease in terms of premature mortality and disability in a particular society.

 Problem statement

Disease burden

Estimating the burden of Neglected Tropical Diseases (NTDs) in Kenya poses a significant challenge due to weak surveillance structures and a resultant scarcity of data. Despite that, more than 25 million Kenyans are believed to be affected by at least one NTD, resulting in a loss of 3-5 million years due to disability and premature death1. In 2019, the economic impact of NTDs was substantial, with the estimated value of healthy life years lost reaching around $900 million2. Although death may not result from NTDs, their adverse effects on individuals’ productivity throughout their lives underscore the necessity of investments from both the global community and governments in controlling NTDs.

 Specifically, by condition, for Trachoma (the leading cause of infectious blindness)3 an estimated 53,200 have already been blinded by the disease4. From recent Trachoma surveys done its estimated that 1,468 persons require surgeries to prevent progression to blindness, with the highest cases in Turkana (636), Narok (537) and West Pokot (295).

Snakebite envenoming (SBE); annual burden of snakebites in Kenya is estimated as 15,411 bites (12,762-18,052), with 719 deaths (566-874) and 848 amputations (566-874)4. Its key to note that this is based on hospital data and underestimates the actual burden of the condition. The affected populations are mostly the economically productive 10–40-year-old, rural poor populations living in tropical areas that majorly depend on agriculture and livestock keeping.

For intestinal worms (STHs and Schistosomiasis), it is estimated that 10 million people are infected mostly in the Coast, Western, Lake Region and pockets of Eastern region and have adverse health and nutritional consequences for children, including stunted growth, weakness, and anaemia.

Rabies is estimated to lead up to 2,000 human deaths annually in Kenya 3. Leishmaniasis (kala azar), an NTD of parasitic origin has a 95% case fatality rate, usually within 2 years if the disease is left untreated. Death is mainly due to organ failure, anemia, or secondary bacterial infections.27 In Kenya majority of patients are

1 WHO NTD Roadmap 2021-2030

2 Kirigia JM, Kubai PK. Monetary Value of Disability-Adjusted Life Years and Potential Productivity doi: 10.2147/RRTM.S382288. PMID: 37408872; PMCID: PMC10317842. 3 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761540/

3 Kenya NTD Master Plan 2023-2027

4 Snakebite burden in Sub-Saharan Africa: estimates from 41 countries. doi: 10.1016/j.toxicon.2018.12.002. Epub 2018 Dec 27. PMID: 3059463