Community Drivers of Leishmania Infection, Transmission and Control in Baringo County, Kenya: Implications for Integrated One Health Intervention Strategies

Leishmaniasis is an endemic zoonotic disease caused by the protozoan parasite Leishmania and transmitted by infected female phlebotomine sandflies. The World Health Organization (WHO) classifies it among the 20 neglected tropical diseases (NTDs), ranking eighth globally. The disease predominantly affects resource-limited populations in tropical regions. Kenya bears a significant global burden of leishmaniasis, with Baringo County identified as a major endemic area. A cross-sectional survey on knowledge, attitudes, and practices (KAP) was conducted from July 2025 to January 2026 among 135 residents of Baringo South Sub-County using a structured questionnaire. The study evaluated sociodemographic characteristics, disease awareness, perceptions, preventive practices, and treatment-seeking behaviors. Additionally, 12 healthcare professionals were interviewed regarding their diagnostic and treatment capacities. Associations between variables were analyzed using Chi-square tests and multivariate logistic regression. Overall awareness of leishmaniasis was high (94.8%), with KAP scores of 86.7%, 76%, and 77.7%, respectively. Despite this, critical knowledge gaps persisted regarding transmission dynamics, the role of dogs as reservoir hosts, and preventive measures. Significant associations were found for awareness of local cases, recognition of clinical signs, knowledge of vector activity, community control measures, and attitudes toward treatment preferences. Age and education level predicted KAP outcomes. Healthcare practitioners demonstrated technical capacity to diagnose and treat human Leishmania infections, whereas veterinarians lacked awareness of Leishmania infection in dogs, including its diagnosis and treatment. Integration of human, animal, and vector surveillance within a One Health framework is recommended to enhance disease monitoring and control in Baringo County.