Risk Factors for Visceral Leishmaniasis in a New Epidemic Site in Amhara Region, Ethiopia

Abstract

We conducted a case-control study to evaluate risk factors for visceral leishmaniasis during an epidemic in a previously unaffected district of Ethiopia. We also collected blood and bone marrow specimens from dogs in the outbreak villages. In multivariable analyses of 171 matched case-control pairs, dog ownership, sleeping under an acacia tree during the day, and habitually sleeping outside at night were associated with significantly increased risk. Specimens from 7 (3.8%) dogs were positive by immunofluorescent antibody test (IFAT) and both enzyme-linked immunosorbent assays (ELISAs), whereas Leishmania DNA was detected in 5 (2.8%) bone marrow aspirates (from 3 seropositive and 2 seronegative dogs). Insecticide-treated nets may only protect a portion of those at risk. Further research on the vectors, the role of the dog in the transmission cycle, and the effect of candidate interventions are needed to design the best strategy for control.

Correlation of Rk39-Specific Antibodies and Thyroid Function in Patients with Visceral Leishmaniasis

“…The minimum age was 5 years and maximum age was 70 years, which was consistent with results of other studies in Brazil, but were less than those of India (mean age, 45 years) [6,14,15]. Sixty-one patients (44.2%) were males, and the mean age was 29.65±11.10 years, which come in line with others [15]. The rest of the patients were females with a mean age of 26.12±11.89 years, minimum age of 5 years, and maximum age of 70 years, which was contrary to results of an Indian study indicated that 93% of affected patients were males.…”

“…The rest of the patients were females with a mean age of 26.12±11.89 years, minimum age of 5 years, and maximum age of 70 years, which was contrary to results of an Indian study indicated that 93% of affected patients were males. In Brazil, 65% of Kala -azar patients were males and in Ethiopia they represents (74%-85.6%) [6,[14][15][16]. High male patient load could be because of the economic activities that entail sex bias.…”

Distribution of Human Leishmaniasis (VL) and Its Associated Risk Factors, in Metemma, Ethiopia

“…Age wise distribution of human leishmaniasis in the study site indicated that it is more common in populations with age of 15 years and above with the rate of 94% similar to [9] who indicated that these adult human beings older than 15 years were more affected compared to the lower age groups. At the same time, [15] indicated that 3.3% children younger than 5 years, 19.2% of children 5-14 years, and 8.6% of adults 40 years or older were affected.…”

“…Since the epidemic of disease is chracterized by high mortality in adults, high disease incidence was observed in age 15-45 groups. The Northwestern VL focus in Ethiopia covers the Semiarid Metemma and Humera plains in Tigray and Amhara regional states bordering Sudan [9].…”

Evaluation of Two rK39 Dipstick Tests, Direct Agglutination Test, and Indirect Fluorescent Antibody Test for Diagnosis of Visceral Leishmaniasis in a New Epidemic Site in Highland Ethiopia

“…In both cases, specificity evaluation was conducted using specimens from healthy controls from the same disease-endemic area. 20 Cases were defined based on the Médecins Sans Frontières VL case definition as modified for a malaria-endemic area, requiring fever for > 2 weeks, splenomegaly and/or abdominal swelling, and/or weight loss; malaria was ruled out based on a rapid antigen detection test. 21 Patients who fulfilled this case definition were eligible to participate as suspected VL patients.…”