1. Gender and Age Stratification in Visceral Leishmaniasis and Diagnostic Test Performance in Kenya

    Vincent Obino Orucho1,  Rael Jepkogei Masai1,  Erick Ondari1, Benuel Nyagaka2

    1. Department of Biological Sciences, Kisii University, Kisii, Kenya.
    2. Department of Applied Health Sciences, Kisii University, Kisii, Kenya.

    Abstract:

    Background and Objectives

    Studies suggest gender and age disparities in infection rates but such data are limited for endemic regions of Kenya. This study aimed to evaluate gender and age disaggregated patterns and diagnostic test performance for visceral leishmaniasis and provide evidence for targeted interventions in endemic areas.

    Methods

    This study analyzed 396 patients (263 males, 133 females) presenting with VL-like symptoms at Chemolingot Hospital between July 2023 and July 2024. Patients were tested for VL using rk39, DAT, Kalazar Detect, and microscopy was used to resolve discrepancies.

    Results

    Out of the 396 patients, 117 (29.5%) tested positive for VL, with 105 (26.6%) showing concordant results across all four tests. Among confirmed VL cases, 74.4% were male. Age-stratified analysis revealed that young people below 20 years accounted for the highest diseases burden (43.2% for below 10yrs and 33.56% for ages 10-20). DAT showed a higher sensitivity (95.6%), NPV (98.2%) and LR- (0.05) while rk39 showed a higher specificity (98.9%), PPV (97.1%) AND LR+ (85.3) when compared.  Diagnostic accuracy of the tests was 97.2, 96.7, 91.9 for rk39, DAT and Kalaazar detect respectively. Spatial analysis indicated regional vulnerability to VL infections with Silale Ward recording the highest VL burden (44.4%) and Lokis the lowest (2.6%).

    Interpretation Conclusion

    VL has a marked male predominance with younger population at a higher risk. Diagnostic performance had varied strengths. DAT and rk39 can used together to give high accuracy of results and reduce dependency on Splenic biopsy which is a painful and risk procedure.

    Key Words: Visceral Leishmaniasis, Gender disparity, Test performance, Anemia.

    Pages: 1 – 12 | Full PDF Paper