Kenya urged to act as malaria drug mutations emerge and neglected diseases spread

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Kenya is facing a new wave of infectious disease threats, as scientists warn that mutations linked to malaria drug resistance are now circulating in the country, while other neglected illnesses such as kala-azar continue to spread into new regions.

Researchers say the developments underline the need for stronger surveillance, targeted clinical trials, and sustainable interventions to prevent the country from losing ground against diseases that disproportionately affect children and vulnerable communities.

Malaria treatment effectiveness is now one of the most urgent concerns, with scientists warning that genetic changes in the parasite could undermine the drugs currently used across the country.

Senior researcher and head of the biosciences department at the KEMRI-Wellcome Trust Research Programme Prof Isabella Oyier says Kenya has detected four mutations associated with reduced response to antimalarial drugs.

“These are mutations that are likely to make the parasite escape treatment. The dominant variant, known as the 675 mutation, is circulating particularly in western Kenya, in counties surrounding Lake Victoria,”Prof Oyier said.

While Kenya’s first-line treatment, Coartem, remains effective for now, the emergence of these mutations signals the need for immediate therapeutic efficacy trials.

“The next steps really would be for the Ministry of Health and the National Malaria Control Programme to set up a clinical trial to determine whether our first-line and second-line anti-malarial drugs are still working,” she said.

Online reports have shown that malaria researchers across East Africa are increasingly concerned that resistance markers once concentrated in Southeast Asia are now appearing in Uganda, Rwanda, Tanzania and Kenya, raising fears of delayed parasite clearance.

Historically, similar mutations have forced global shifts in treatment policy, with drugs like chloroquine and later sulfadoxine-pyrimethamine abandoned after resistance spread widely.

“Mutations happen naturally, but if that mutation has an advantage against the drug, it will rise to high frequency because the parasite is escaping treatment,” Prof Oyier said.

Beyond malaria, scientists are also warning about the growing burden of kala-azar, a deadly disease transmitted by sandflies and increasingly affecting young people in Kenya’s arid and semi-arid counties.

The head of human health at the International Centre of Insect Physiology and Ecology (ICIPE) Dr Daniel Masiga says East Africa has now become the epicentre of visceral leishmaniasis transmission globally.

“The disease is clustered in certain areas, but we are also seeing it in counties that are not considered endemic. That means surveillance systems must expand beyond the traditionally recognised hotspots,” Masiga said.

“That shows transmission is happening not just when people are out herding cattle, but also around the homesteads. Control strategies must take into consideration those diversities,” he said.

Masiga stressed that county governments must take a more active role rather than leaving the response solely to national authorities.

“Success in places like Asia involved understanding transmission dynamics. Here, there is a lot of need for research in vector ecology and disease modelling so that resources are better utilised,” he said.

The role of modelling and data in guiding outbreak response has also become increasingly critical.

Prof Thumbi Mwangi, a professor of infectious disease epidemiology at the University of Nairobi and director of the Centre for Epidemiological Modelling and Analysis (CEMA), says timely interventions can mean the difference between containment and crisis.

“If we vaccinated 20 days after the first case, we only averted 35 percent of eventual cases. But had we gotten vaccines earlier, we would have averted nearly 70 percent,” Mwangi said.

“To make that kind of decision, you need all the data and good mathematics,” he said.

Scientists are also exploring ecological approaches to disease control, including biological solutions to combat bilharzia and invasive snail species threatening both health and agriculture.

Prof Amir Saghi of Ben-Gurion University says Kenya is facing two linked crises, bilharzia infections spread by freshwater snails, and an invasive snail that has reduced rice yields by an estimated 40 percent in affected fields.

“What we suggest is to use a sustainable way of eradicating snails, not with chemicals but with biocontrol,” Saghi said.

“This is a win-win situation. Farmers would not only reduce disease risk but also gain another source of protein and income,” he said.

From malaria mutations in western Kenya to kala-azar spreading into new counties, researchers say Kenya must strengthen surveillance, invest in evidence-based interventions, and act early before warning signs turn into full-scale public health crises.