Attachments
A. SITUATION ANALYSIS
Description of the disaster
Kenya has been affected by numerous health crises and natural disasters in the past two years. More than 4 million people were affected by drought coupled with the negative effects of COVID-19 on the economy, the situation was very dire among the poor and those in the hard-to-reach areas of the country (mostly in the arid and semi-arid areas) which, as a result, were the localities most affected by health crises. The emergence and re-emergence of viral infections transmitted by vectors in the country namely Chikungunya, Dengue, Yellow Fever (YF), and others was a cause for international concern. The first two months of the year 2022 Kenya recorded two outbreaks that were being responded to under this operation: Yellow Fever and Chikungunya in Isiolo and Wajir counties respectively.
Yellow Fever
Cases of Yellow Fever were first reported in January 2022 in Merti Sub County of Isiolo County. On 27 July 2022, an outbreak of Yellow fever was confirmed in two (2) Counties, Isiolo and Garissa. Suspected cases have been reported from other ten (10) Counties, Samburu, Meru, Wajir, Nakuru, Mombasa, Nairobi, Tana River, Turkana, Trans Nzoia, and Laikipia. A total of one hundred and forty-one (141) cases with three (3) Confirmed positive, eight (9) Presumptive positive cases, and eleven (11) deaths have been reported (CFR of 7.8%). Two new cases were reported from Mombasa and Isiolo respectively. The last case date of onset was on 3 October 2022.
Up until end of August 2022, the yellow fever outbreak in Isiolo County, where the DREF response was being implemented for yellow fever response had recorded 71 suspected cases and 7 deaths while Garissa County recorded 1 case. 6 presumptive positive cases and 2 confirmed cases were also recorded in Isiolo county. The map below illustrates the number of presumptive positive/confirmed cases in Isiolo county and their distribution per ward.
The first confirmed case took 3 weeks, indicating the lengthy process that was undertaken for transportation of samples and laboratory testing. The epidemiological situation was limited by capacity in the remote areas affected and the fact that that the region had not traditionally been affected by yellow fever in the past. The considerable gaps and the outbreak trend in that context was therefore an indication that more needed to be done with regards to community sensitization, vaccination and prevention against yellow fever in the 2 two affected counties as they border each other. The graph below indicates the epi curve of yellow fever up until Oct 2022.
Chikungunya
In March 2022, Chikungunya outbreak was reported in Wajir County, Tarbaj sub county in Kutulo village with a total of forty-four (44) cases reported with two (2) confirmed cases at the time. In the past, Wajir County reported cases of chikungunya from Tarbaj sub-county in Kutulo village dating back November 2021. A total of two hundred and ninetyone (291) cases have been reported with five (5) confirmed cases and one (1) death (CFR 0.3%). The graph below depicts the epi curve of the disease since Nov 2021 to Sep 2022.
With the outbreaks of both Yellow Fever and Chikungunya and their severity, there was need to upscale response actions to avert further spread and morbidity as a result of the diseases. The capacity of the remote county health systems was also wanting hence the need for capacity building. Upscaling of community mobilization as well as sensitizations of the various IPC measures was also of paramount importance.
The drought situation also added to the vulnerability of the affected communities by the outbreak. Already an upsurge of Kalazah cases was being witnessed in Isiolo County in Merti subcounty and parts of Garbatulla subcounty as well as, Wajir County from Wajir East, west, South and Eldas sub counties among other counties in the country. These vectors borne disease outbreaks coupled up with the wanting health system capacities and severity of the situation if the outbreak were to be full blown necessitated the need to have a coordinated response of vector borne diseases affecting the target counties. The table and bar graph below illustrates kalazah cases and epi curve: