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In South Sudan, Deadly Kala Azar on the Rise


Matthew Buru, 4, undergoes intravenous treatment for cholera at an MSF treatment center near Juba earlier this year. MSF says cholera cases are down but cases of kala azar are up sharply.
Matthew Buru, 4, undergoes intravenous treatment for cholera at an MSF treatment center near Juba earlier this year. MSF says cholera cases are down but cases of kala azar are up sharply.

Officials with international medical charity Doctors Without Borders (MSF) said Thursday that a killer disease is on the rise in South Sudan, just as the deadly cholera outbreak in the country appears to be under control.

As one MSF official announced in a statement that the organization has started scaling down its cholera operations in South Sudan after seeing a significant decline in the number of new cases in recent weeks, another said cases of kala azar -- the second most deadly parasitic disease in the world after malaria -- were up sharply.

The number of people seeking treatment for kala azar has almost doubled this year compared to last, MSF Deputy Medical Coordinator, Dr. Ahmed Abdi said.

"Since April, up to now, we have treated 2,000 kala azar patients, compared to last year, when we treated 1300,” Abdi said.

Most of the patients seeking treatment for the illness are in Upper Nile, Unity and Jonglei states, the three states that have been hardest hit by fighting that broke out in South Sudan in December.

Displaced more susceptible

Abdi blamed the increase in cases of the disease, which is transmitted through the bite of female sand flies, on the fact that hundreds of thousands of South Sudanese have been displaced by the conflict and are living in the open.

“If you don’t have bed nets or if you are not sleeping inside a house or a tukul, then you are more prone to the disease. Sometimes in the hospital we do have a family... in which all four children have kala azar," he said.

Food insecurity is also making South Sudanese more vulnerable to kala azar, Abdi said. U.N. agencies in South Sudan have said around four million people in the country are food insecure.

Malnutrition weakens the immune system which leaves people more vulnerable to diseases such as kala azar, Abdi said.

MSF has treated more than 16,000 children for malnutrition since January in the three states where kala azar is a problem. In Upper Nile state alone, the medical charity has treated nearly 900 people for kala azar since April this year, Abdi said.

100-percent fatal in two years

Also known as visceral leishmaniasis, kala azar "can be 100-percent fatal within two years" if left untreated, according to the World Health Organization.

In the early stages of infection, sufferers have skin sores or ulcers at the spot where they were bitten by the sand fly. If the disease is not caught early, it attacks the immune system.

Abdi said that in addition to living out in the open, which heightens the risk of being bitten by a female sand fly and getting kala azar, most people who are infected have to travel long distances to seek treatment for the disease because many health facilities in South Sudan have been destroyed during the conflict.

The rainy season only makes matters worse and Abdi said he fears some people could die on their way to get treatment.

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