Kala-Azar Outbreak in Libo Kemkem, Ethiopia: Epidemiologic and Parasitologic Assessment

Abstract

In May 2005, visceral leishmaniasis (VL) was recognized for the first time in Libo Kemkem, Ethiopia. In October 2005, a rapid assessment was conducted using data from 492 patients with VL treated in the district health center and a household survey of 584 residents of four villages. One subdistrict accounted for 71% of early cases, but the incidence and number of affected subdistricts increased progressively throughout 2004-2005. In household-based data, we identified 9 treated VL cases, 12 current untreated cases, and 19 deaths attributable to VL (cumulative incidence, 7%). Thirty percent of participants were leishmanin skin test positive (men, 34%; women, 26%; P = 0.06). VL was more common in men than women (9.7% versus 4.5%, P < 0.05), possibly reflecting male outdoor sleeping habits. Molecular typing in splenic aspirates showed L. infantum (six) and L. donovani (one). Local transmission resulted from multiple introductions, is now well established, and will be difficult to eradicate.

Identification of environmental parameters and risk mapping of visceral leishmaniasis in Ethiopia by using geographical information systems and a statistical approach

“…The Elnaiem et al (2003) study in Gedaref state of Sudan, using a probabilistic model, concluded that altitude is one of the best predictors for the presence of VL in a village. The long-known endemic foci established through epidemiological surveys and self-reported cases of VL in Ethiopia are from the lowlands and the recently reported highland foci range from 1,800 to 2,000 m (Ali et al, 1994;Hailu et al, 1996;Alvar et al, 2007;Herrero et al, 2009;Sordo et al, 2012).…”

Who Is a Typical Patient with Visceral Leishmaniasis? Characterizing the Demographic and Nutritional Profile of Patients in Brazil, East Africa, and South Asia

“…This has been reported previously. 19,20,[22][23][24][25] It is unclear whether this is because of factors such as increased exposure, vulnerability, or health-seeking behavior (it is possible that male patients are more likely to present to health centers for care) and how these factors vary in the different epidemiological and cultural settings. Populations were younger in Latin America than in Africa and South Asia.…”

Transmission dynamics and underreporting of Kala-azar in the Indian state of Bihar

“…The variability in the infectious period, intrinsic and extrinsic incubation/latent periods, is in the distributions for m 1 , n 1 and n 2 , respectively. Discrete (integer value) uniform distributions are chosen for m 1 , n 1 and n 2 with estimated ranges in the intervals [1,3], [4,28] and [11,39], respectively (see references in Table 2 and references [1,3,4,7,29,36]). …”