HIV/AIDS, neonatal disorders, diarrheal diseases, lower respiratory infections, congenital defects, tuberculosis, stroke, ischemic heart disease, meningitis, cirrhosis were the top 10 causes of death and disability-adjusted life years (DALYs) combined in 2017 in Kenya (all ages and sexes combined) (Institute for Health Metrics and Evaluation, 2017)

Although HIV prevalence in Kenya reduced from 7.2% (excluding North-Eastern region) in 2007 to 5.6% and an incidence of 0.5% in 2012 with similar decline across males and females, it continues to be a public health concern due to the annual transmission rate of 8.9 per 100 HIV-infected persons. In 2012, HIV prevalence peaked (9.8%)  among those aged 45-49 while in 2007 the highest prevalence (11.9%) was seen among those aged 30-34 (Kimanga et al., 2016).

Kenya was also hit by the global pandemic of corona virus disease (COVID-19) which was first detected in China on 31^st December 2019. In March 2020, the first case was confirmed. Older people have experienced a double blow during the pandemic as they are at a higher risk of developing dementia and are vulnerable to frailty and comorbid conditions. By 12^th April 2020, 7% of COVID-19 cases (out of 197) were aged 60 years. In addition, most deaths across the globe were older adults with underlying health issues (Lloyd-Sherlock et al., 2020).  Unfortunately, non-governmental organizations (NGOs) offering support to persons with dementia and their caregivers remain scarce in  Kenya, yet that is the only face-to-face and practical option for the increasing cases of dementia (Comas-Herrera et al., 2020).

The World Health Organization (WHO) and the government of Kenya has continuously put in strict safety measures to reduce further infection of COVID-19 such as physical distancing, wearing masks, hand washing and other sanitization procedures. In some countries like Kenya, measures to reduce public gatherings and crowds included government curfew and minimal movement outside major counties affected by COVID-19. Some of the measures may pose difficulties for persons with dementia such as remembering these instructions since decline in memory is a key presentation for dementia. As a result, persons with dementia may be predisposed to infection (Wang et al., 2020) or experience legal consequences because there have not been exceptions or guidelines that have been put in place for persons with disability such as dementia.

References:

Comas-Herrera, A., Lorenz-Dant, K., Ferri, C., Govia, I., Sani, T., Jacobs, R., … The STRiDE Team. (2020). Supporting people living with dementia and their carers in low- and middle-income countries during COVID-19. LTCcovid.Org, International Long-Term Care Policy Network, CPEC-LSE, April, 7–10. https://ltccovid.org/2020/04/10/supporting-people-living-with-dementia-and-their-carers-in-low-and-middle-income-countries-during-covid-19/

Institute for Health Metrics and Evaluation. (2017). Country profiles: Kenya – What causes the most death and disability combined? https://www.healthdata.org/kenya

Kimanga, D., Ogola, S., & Umuro, M. (2016). Prevalence and Incidence of HIV Infection, Trends, and Risk Factors Among Persons Aged 15–64 Years in Kenya: Results From a Nationally Representative Study. Journal of Acquired Immune Deficiency Syndromes, 1999(66(Suppl 1)), 13–26. https://doi.org/10.1097/QAI.0000000000000124

Lloyd-Sherlock, P., Ebrahim, S., Geffen, L., & McKee, M. (2020). Bearing the brunt of covid-19: older people in low and middle income countries. BMJ, 368, 1–2. https://doi.org/10.1136/bmj.m1052

Wang, H., Li, T., Barbarino, P., Gauthier, S., Brodaty, H., Molinuevo, J. L., … Tang, Y. (2020). Dementia care during COVID-19. Lancet (London, England), 395(10231), 1190. https://doi.org/10.1016/S0140-6736(20)30755-8