By Yusef Taylor, @FlexDan_YT
A situation report released by the Epidemiology and Disease Control Unit (EDC) under the Ministry of Health (MoH) has stated that 28 children have died out of 35 reported cases of an unidentified Acute Kidney Injury (AKI) on Monday 8th August 2022.
The situation report noted that “over 35 cases were reported, while only 32 met the event-based case definition with 28 deaths”. This translates to an 87.5% death rate in this deadly disease. A map of the incidents that have occurred indicates that the majority are in the Upper River Region while less than five (5) are located in the Western Region and Banjul.
The “event case definition” is defined as “any child less than 5 years of age with sudden failure to pass urine for more than a day with any of the following: fever, diarrhoea or vomiting from the 24th June 2022 to date”.
Earlier this week a press release issued by the Edward Francis Small Teaching Hospital [EFSTH] notified the general public that “there is a rare condition currently under observation in the Paediatric Outpatient. Samples were collected from the affected children and awaiting results from the lab”.
The EFSTH press release added that the patients “were present with diarrhoea, vomiting and reduced urination output. It is severe and already causing mortality in children”. The public notice didn’t disclose the number of deaths, however, it highlighted that “doctors are working very hard to establish the cause of the condition”.
Highlighting the commencement of efforts to track the disease the EDC report from the MoH notes that “on the 26th July 2022, the EDC unit received a report through the Director of Health Services from a concerned nephrologist of a sudden rise in cases of AKI among children aged 5months – 4yrs”.
According to the EDC report, the investigation started on 19th July 2022 and the report was issued on the 8th of August 2022. Findings of the investigation note that “AKI is an abrupt (within hours) decrease in kidney function, which encompasses both injury (structural damage) and impairment (loss of function)”.
The EDC report notes that the disease “is a syndrome that rarely has a sole and distinct pathophysiology. Many patients with AKI have a mixed aetiology where the presence of sepsis, ischaemia and nephrotoxicity often co-exist and complicate recognition and treatment”.
To get some expert opinion on the EDC report, our reporter spoke to Health Expert, Mr Phillip Saine who has amassed two decades of experience in the health sector. After reviewing the EDC report, Mr Saine noted that “at this stage, it is very early to know exactly what is happening. They are doing things scientifically to come to a logical conclusion of what is happening”.
According to the Health Expert, the EDC report currently identifies “symptoms which are rare and the disease is highly fatal which is very worrying and very rare”. In addition to that, there is a “need to do thorough laboratory investigation plus epidemiological investigations”.
However, some concerns noted by the Health Expert indicate that “they have started the epidemiological investigations but it’s being hampered by lack of resources”. The EDC report highlights that “inadequate vehicle and fuel supply to conduct field investigation” and “lack of funds to support payment of daily service allowance for field investigators” are challenges observed during the investigation.
Another point of concern was raised by the Health Expert who stated that the MoH are “sending some samples to Dakar, this also hints at the inadequacy of our public health laboratory”. The EDC report notes that urine and stool samples are being tested in the Gambia’s National Public Health Laboratory while “blood and drug samples were sent to Centre Anti-Poison du Senegal Hospital de Fann”.