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Sub-national estimates of visceral leishmaniasis and optimisation of geographical accessibility to treatment centres in Kenya
2026
Research Paper
Authors
Topics
Visceral LeishmaniasisKenyaEliminationGeospatial AnalysisBayesian ModellingHealthcare AccessPublic Health
Objectives
The study aimed to estimate sub-national incidence of visceral leishmaniasis (VL) in Kenya, identify its environmental, socioeconomic and accessibility determinants, and optimise the geographical placement of treatment centres to improve access to care.
Methods
Nine years (October 2016 to September 2025) of ward-level VL surveillance data from health facilities were analysed with WorldPop population denominators. Bayesian small-area models related case occurrence and counts to environmental, socioeconomic and accessibility covariates. Travel time to the 46 existing treatment centres was computed over a motorised friction surface, and additional sites were prioritised to maximise population coverage.
Results
The study recorded 11,985 cases, an estimated incidence of 10 per 100,000 population per year, with marked seasonality and epidemic periods. Burden is highly focal: five northern counties account for 86% of cases, and predicted incidence exceeds 100 per 100,000 person-years in several wards in Turkana and West Pokot. Higher temperature, poverty and poor housing were associated with a greater probability of occurrence and higher case counts, while higher precipitation was inversely associated. Only 45% of the population in need can reach a treatment centre within 120 minutes of motorised travel; five optimally sited additions raise this coverage to 76%, with diminishing gains from further expansion.
Conclusions
Integrating small-area disease modelling with geospatial accessibility analysis reveals hidden inequities in VL burden and supports equitable, efficient deployment of treatment services towards elimination.