Risk factors of visceral leishmaniasis: A case control study in north-western Ethiopia

Solomon Yared*, Kebede Deribe, Araya Gebreselassie, Wessenseged Lemma, Essayas Akililu, Oscar D. Kirstein, Meshesha Balkew, Alon Warburg, Teshome Gebre-Michael, Asrat Hailu

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Background: Visceral leishmaniasis (VL, also called kala-azar"), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL. Methods: A case control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL. Results: Elevated odds of VL was associated with goat ownership (OR = 6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR = 6.4; 95% Cl: 1.6-25.6), increased family size (OR = 1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR = 1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR = 0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR = 0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR = 0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case. Conclusion: Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants.

Original languageAmerican English
Article number470
JournalParasites and Vectors
Volume7
Issue number1
DOIs
StatePublished - 2014

Bibliographical note

Funding Information:
This study was supported by Bill and Melinda Gates Foundation Global Health Program (grant number OPPGH5336). KD is supported by the Wellcome Trust Fellowship in Public Health and Tropical Medicine [grant number 099876]. We gratefully acknowledge Nurse Seltan Gebreselassie, and laboratory technician Shumuye Hagos for their assistance with collection of blood samples and separating serum at Setit Humera Health Centre. We thank Mokennen Arefaiene (head of Adebay Health centre) and Berhe Gebremeskel for identifying VL patients based on their address as well as cooperating and performing the questionnaires. We also thank Welelta Shiferaw and Asrat Bezuneh for their assistance in testing the blood samples using DAT. The Aklilu Lemma Institute of Pathobiology and Department of Medical Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University are acknowledged for allowing and supporting the study. Finally, we warmly thank the participants of the study and Kahsay Abera Hospital ward section for availing VL data.

Publisher Copyright:
© 2014 Yared et al.

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