Visceral leishmaniasis in Somalia: A review of epidemiology and access to care - Project 1.7 journal article

Authors: Temmy Sunyoto, Julien Potet, and Marleen Boelaert

Journal: PLOS Neglected Tropical Diseases 11(3)


Somalia, ravaged by conflict since 1991, has areas endemic for visceral leishmaniasis (VL),
a deadly parasitic disease affecting the rural poor, internally displaced, and pastoralists.
Very little is known about VL burden in Somalia, where the protracted crisis hampers access
to health care. We reviewed evidence about VL epidemiology in Somalia and appraised control
options within the context of this fragile state's health system. VL has been reported in
Somalia since 1934 and has persisted ever since in foci in the southern parts of the country.
The only feasible VL control option is early diagnosis and treatment, currently mostly provided
by nonstate actors. The availability of VL care in Somalia is limited and insufficient at
best, both in coverage and quality. Precarious security remains a major obstacle to reach
VL patients in the endemic areas, and the true VL burden and its impact remain unknown.
Locally adjusted, innovative approaches in VL care provision should be explored, without
undermining ongoing health system development in Somalia. Ensuring VL care is accessible
is a moral imperative, and the limitations of the current VL diagnostic and treatment tools
in Somalia and other endemic settings affected by conflict should be overcome.