Health Ministry raises alarm over high worm burden in 15 counties amid open defecation crisis

A significant portion of Kenya's population continues to practice open defecation, contributing to high rates of worm infections across the country, the Ministry of Health has revealed.

Despite ongoing public health efforts, reports from the Ministry indicate that approximately four out of every 10 Kenyans, nearly five million people, engage in open defecation, leading to severe public health consequences.

According to data from the State Department of Public Health and Professional Standards, 15 counties are currently listed as having a high worm burden. In total, 27 counties are severely affected, with regions in Western Kenya and along the Coast experiencing worm infection rates of 40-50 per cent.

Officials estimate that over 20 million Kenyans are infected with worms, necessitating urgent treatment. Additionally, over a million schoolchildren are significantly affected, with infections impacting their health, school attendance and academic performance.

"Untreated communities act as reservoirs for transmitting re-infections to pupils, hence the push for a synchronised mass drug administration for the nation," the department's latest data highlights.

Public Health Principal Secretary Mary Muthoni noted that worms which affect humans are known as soil-transmitted helminths which are acquired through infective eggs found in soil that is contaminated with feaces of an infected person, in areas where sanitation and hygiene are poor.

She added that Bilharzia, another common infection, is transmitted through contaminated freshwater, often found in rice fields and other water bodies.

"The eggs can be swallowed or can burrow the skin of a person and migrate to stay in the intestines as parasites and cause infection and ill health, while the bilharzia worms can penetrate the skin and in addition to the intestines reside in the wall of the urinary bladder and cause an infected person to urinate bloody urine," she said.

Soil-transmitted worms (helminths) are a group of three parasites namely roundworms (Ascaris Lumbricoides), whipworms (Trichuris trichuria) and hookworms (Ancylostoma & Necatar). Bilharzia (Schistosomiasis) is also a hookworm.

According to the Ministry's data, children aged two to 14 years are more likely to be infected by these worms and the effect on their health is far much worse as compared to adults.

Absorption of nutrients

PS Muthoni noted that worm infections can reduce the absorption of nutrients in the body, leading to anemia and malnutrition, and weaken the body’s immunological response to other infections such as malaria.

"Infected children may become too sick to attend a school or too tired to concentrate in class, while infected women of reproductive age face compounded health issues due to iron deficiency anaemia," she said.

For infected girls and women of reproductive age, Muthoni said, blood loss worsens iron deficiency anaemia that is routinely caused by menstruation blood loss, hence causing far much worse ill health effects.

She emphasised on the need for continued deworming programs and improved sanitation practices to combat these infections.

The report indicates that deworming initiatives have yielded positive results, reducing school absenteeism by 25 per cent and improving the nutritional status of children.

These efforts have led to an average weight gain of one kilogramme among children aged 2-14.

The Ministry also advocated for periodic treatment with deworming tablets, health education, and improved sanitation to prevent re-infection and reduce soil contamination.

These measures are part of a broader strategy to eliminate worm infections in Kenya by 2030, in line with the World Health Organization's recommendations for periodic mass administration of deworming drugs in high-burden areas.

The Ministry's efforts are also supported by development partners and stakeholders in the water, hygiene and sanitation sectors.

"We are working to address the nearly five million people in Kenya still practising open defecation, particularly in the 15 high worm burden counties," Muthoni said.

These initiatives include targeted health education, infrastructural investments, and a nationwide campaign to achieve open defecation-free status by 2030.

"Countries like Japan have successfully eliminated worm infections through comprehensive deworming programmes combined with robust public education on hygiene and sanitation," PS Muthoni noted, expressing optimism for Kenya's future efforts in eliminating this public health burden.