Mary Alamak was infected with visceral leishmaniasis, also known as kala-azar, while she was pregnant 13 years ago. Nothing prepared her for the anguish she would face trying to find out what she was ailing from.
The mother of four from Longelai Village in West Pokot County, Kenya rapidly lost weight, going from 80 kg to just 45 kg. She had to be carried around because she was too weak to walk and sank into a depression, fearful of losing her baby. A series of tests for malaria, HIV, and brucellosis at the Kacheliba Sub-County Hospital all came back negative.
‘My health continued to deteriorate by the day. I could barely eat, the fevers were persistent, and my stomach was in so much pain. I thought it was the pregnancy that was causing my misery.’Mary Alamak
After a month of distress, it was finally confirmed that she had visceral leishmaniasis, after she told her doctor that her husband had experienced the same symptoms and had been treated for this neglected tropical disease. Mary was immediately put on treatment with liposomal amphotericin B, the second-line treatment used to treat visceral leishmaniasis in patients who don’t respond to the first-line treatment. This treatment is also used to treat special populations such as pregnant women, people over 65 years of age, and children less than two years old. This 10-day treatment is effective but very expensive and needs to be stored at 2–8°C, which presents a challenge for many of the hospitals in endemic regions.
Mary is among the lucky few to receive effective treatment to cure visceral leishmaniasis. There has been little research conducted to find new, better, and more affordable treatments for special populations such as expectant and lactating women. Women are often excluded from clinical trials, making it difficult to develop drugs that are safe and effective during pregnancy.
DNDi is committed to implementing best practices in gender-responsive drug development and treatment access programmes, and supporting maternal health. DNDi’s ultimate goal is to develop new medicines to treat visceral leishmaniasis that are safe, effective, and affordable for everyone – including women during pregnancy.
Photo credit: Paul Kamau/DNDi