Malaria and Chikungunya outbreak in Marsabit County, Kenya, May 2023: a descriptive study

Acute febrile illnesses are common causes of seeking health care in Sub-Sahara Africa especially among the under-five years. Understanding their causative pathogen is critical for optimal patient management. We characterized a febrile illness outbreak in Marsabit County to determine the magnitude of an outbreak, describe the epidemiology and clinical characteristics of the outbreak and conduct Risk Communication and Community Engagement (RCCE). A retrospective review of laboratory registers and patients’ clinical notes was done at Kargi Health Centre, Korr Health Centre and Laisamis Sub-county Hospital. A case of febrile illness was any person living in or has travelled to Laisamis Sub-county presenting with fever ≥ 380 C or headache at the health facility or in the community from 1st May to 24th May 2023. Cases of febrile illness were interviewed using a structured questionnaire to collect clinical and epidemiologic information. Approximately 4–5 ml of blood was collected from cases of febrile illness for laboratory differential diagnosis. Risk Communication and Community Engagement activities were conducted included interpersonal communication, focused manyatta group discussions and sensitization of community health promoters. A total of 184 febrile cases were line listed. Eighteen cases of Chikungunya and 12 cases of malaria were confirmed from the 72-blood specimen analysed during the investigation period. Of the 12 samples that tested positives for malaria, 11 were P. falciparum and one P. vivax. Of the 72 blood specimen analysed, three had dual infection. One mortality was reported, involving a case co-infected with Malaria P. falciparum and Chikungunya . Thirteen Manyattas were visited where interpersonal communication was conducted as well as focused group discussion among manyatta residents and manyatta leaders. Two hundred Community Health Volunteers were sensitized on mosquito-borne diseases prevention and control in Laisamis Town. There was low knowledge on causes of febrile illness especially malaria. The outbreak was driven by two infections; Chikungunya virus infection and Malaria infection. Sustained surveillance, vector control programs and awareness promotion are needed for early detection and control of possible mosquito-borne outbreaks.