Kenya reported 71 new cases of measles last week and a new cholera outbreak

Kenya recorded 71 new measles cases last week as the total number of incidents jumped to 612  from 541 in the previous week.

The recent disease emergency update of the World Health Organisation (WHO) published on Monday shows the outbreak still active in Mandera, Garissa, Nairobi, Wajir and Muranga counties.

It also reported 40 cases of  cholera since September  from Turkana, Embu and Isiolo counties in a new wave of cholera outbreak.

Cumulatively, as of 30 October 2018, 5 796 cases of cholera including 78 deaths  have been reported since 1 January 2018 in 20 out of 47 counties.

Meanwhile the measles outbreak continues to march on as Kenya records worst child vaccination coverage in 15 years

The current numbers are a four-fold increase since the Government reported the outbreak in June.

In June the Director of Medical Services Dr Jackson Kioko, said a measles outbreak had affected 142 people in Mandera and Wajir counties.

However Dr Kioko quickly assured Kenyans that the outbreak had been successfully contained.

“This has been done through active case searches, their management and enhanced vaccination services,” he had said in a statement.

But the current weekly bulletin of the WHO on disease emergencies shows the measles outbreak in Kenya is neither contained nor stopped.

The report for the week ending  2nd November records 612 cases and one death in the ongoing outbreak in Mandera, Garissa, Nairobi and Wajir counties.

This is 71 cases more than reported by the WHO in the previous week.

“Since the beginning of the year, five counties of Mandera, Wajir, Garissa, Nairobi and Kitui have reported measles outbreak,” says the latest WHO update

The data usually presented to WHO by the Member Country says while Kitui is not reporting any more cases, the outbreak “is still active in Mandera, Garissa, Nairobi and Wajir counties.”

The outbreak is ongoing at a time 584,152 children have not been fully immunized against several life threatening diseases.

A recent presentation by Dr Peter Okoth of UNICEF, Nairobi, shows Kenya has not met its national child immunization targets of 85 per cent since 2013.

During the period national measles vaccine coverage dropped from a regrettable 79 per cent in 2013 to a disappointing 68 per cent last year, the lowest in 15 years.

Some 460,288 children did not get vaccinated against measles last year almost twice those not covered 2014.

The five top counties with the highest number of children not vaccinated against measles in 2017 were Mandera, Kisii, Narok, Kilifi and Trans Nzoia.

The five accounted for 114,000 children not vaccinated against measles last year.

In a presentation at a recent conference of the Kenya Paediatric Association, Dr Okoth said the drop is mainly an outcome of health workers’ strikes in the last two years.

The report shows counties which experienced the most days of health workers strike also to have high rates of unvaccinated children such as Migori and Baringo.

Between 2014 and 2017, Baringo recorded the highest number of health workers strike days, 392, followed by Migori at 280.

The report, for example shows Pentavalent vaccine, which protects against five life-threatening diseases to have dipped the steepest in November 2016 when doctors and nurses were on strike.

Huge drop in child vaccines were also recorded in June and July last year when nurses went on strike.

“Strikes by nurses and doctors have huge impact on overall and effective coverage of child immunizations,” said Dr Okoth.

This he said may be driving the country to a return of vaccine preventable diseases such as measles, pneumonia and tuberculosis.

But the strike does not tell the whole story since the immunization numbers have been falling since 2013 and soon after devolution.

While releasing a report on the state of immunization in Kenya in August, Dr Sammy Mahugu the head of the Health Promotion Unit at the ministry blamed county government for not prioritising vaccination.

“Before devolution, immunization coverage in most parts of the country stood at 70 per cent. After devolution, however, it has dropped to less than 50 per cent in most counties,” Dr Mahugu had said.

But despite children immunization being funded by donors, many counties have been characterized with high rates of vaccines and vaccine devices stock outs.

The top four countries indicated with chronic stockouts in 2014 – 2017 included Nyamira, Narok. Makueni, Kisii, Kilifi and Kirinyaga.

The situation is so bad that in July President Uhuru Kenyatta issued a directive ordering all 47 counties to ensure all children were inoculated within the next 100 days.

But counties have called on such directives to be accompanied with necessary resources.

The Council of Governors has called on all resources for devolved functions, including donor money, channeled directly to counties.

“We want all monies for health sent to the counties and we want it now,” Council of Governors Chairman Josphat Nanok said earlier this year.

Currently much of the cost for vaccines in met by donors through GAVI Alliance which has covered Kenya up to 2019 at Sh47 billion.

Kenya is only spending about Sh1.4 billion annually on vaccines but this will change after 2022.

After graduating to a low-middle income county, Kenya is now scheduled to shoulder its vaccines burden.

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