Paper: Studies in leishmaniasis in East Africa I. The epidemiology of an outbreak of Kala-azar in Kenya

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Abstract
The epidemic outbreak of kala-azar in the Kitui district of Kenya, Africa, led to an attempt to determine the probable vector and the probable animal reservoir. Fifteen spp. of sandflies (8 of them new spp.) were examined, and one of the new species - Phlebotomus (Sergentomyia) sp? is regarded as the most probable vector. It is a normal inhabitant of termite hills and is one of the few "bush" forms feeding on humans and capable of developing leptomonads of the human leishmania type. However, all attempts to initiate artificial infections in this species by L. donovani were unsucessful. Most sandflies feed on reptile blood, even those most abundant around habitations, so are not probable vectors. Of 16 spp. of mammals of the area including jackals and 100 native dogs examined for leishmania none was found that seemed a possible reservoir of infection. Gerbils and mongooses seem to be the most likely possibilities, and further investigations are in progress along this line. As yet, however, no indication of the original source of the infection, a definite vector, or a probable animal reservoir has been brought to light, even though the epidemic is still present. Possibly inter-human transmission will be found the true answer, as is known to be the case in a few instances elsewhere in the world.

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