The epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994.

Hdl Handle:
http://hdl.handle.net/10144/23159
Title:
The epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994.
Authors:
Seaman, J; Mercer, A; Sondorp, H
Journal:
International Journal of Epidemiology
Abstract:
BACKGROUND: Although endemic in parts of southern Sudan, visceral leishmaniasis (VL) had not been reported in Western Upper Nile (WUN) until an epidemic was confirmed in 1989. A combination of circumstances created conditions for transmission among a population of mainly Nuer and Dinka people who had no immunity. The civil war which restarted in 1983 has been a major contributing cause and continues to hinder provision of treatment, data collection and control measures. METHODS: Since the first of three clinics to treat VL was established in WUN in 1989, data on the epidemic and mortality have been collected in seven retrospective surveys of villages and among patients. Adults were interviewed about surviving family members and those who had died since the epidemic came. Survey death rates are used here to estimate mortality from VL and 'excess mortality' above expected levels. RESULTS: The surveys found high mortality at all ages and suggest an overall death rate of 38-57% since the epidemic started in 1984, and up to 70% in the most affected areas. Both methods of estimation suggest that around 100,000 deaths, among about 280,000 people in the epidemic area, might be attributable to VL. CONCLUSIONS: This continuing epidemic has shown that VL can cause high mortality in an outbreak with astonishingly high infection rates. Population movement has been a major factor in transmission and poor nutritional status has probably contributed to the risk of clinical infection. Although over 17,000 people have been successfully treated for VL at the clinics in WUN, the disease is likely to become endemic there.
Affiliation:
MSF (Médecins sans Frontières)-Holland, Amsterdam, The Netherlands.
Publisher:
Oxford University Press
Issue Date:
Aug-1996
URI:
http://hdl.handle.net/10144/23159
PubMed ID:
8921468
Additional Links:
http://ije.oxfordjournals.org/cgi/reprint/25/4/862.pdf
Language:
en
Description:
To access this article, click on "Additional Links"
ISSN:
0300-5771
Appears in Collections:
Leishmaniasis/Kala Azar

Full metadata record

DC FieldValue Language
dc.contributor.authorSeaman, J-
dc.contributor.authorMercer, A-
dc.contributor.authorSondorp, H-
dc.date.accessioned2008-04-14T11:06:49Z-
dc.date.available2008-04-14T11:06:49Z-
dc.date.issued1996-08-
dc.identifier.citationThe epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994. 1996, 25 (4):862-71notInt J Epidemiolen
dc.identifier.issn0300-5771-
dc.identifier.pmid8921468-
dc.identifier.urihttp://hdl.handle.net/10144/23159-
dc.descriptionTo access this article, click on "Additional Links"en
dc.description.abstractBACKGROUND: Although endemic in parts of southern Sudan, visceral leishmaniasis (VL) had not been reported in Western Upper Nile (WUN) until an epidemic was confirmed in 1989. A combination of circumstances created conditions for transmission among a population of mainly Nuer and Dinka people who had no immunity. The civil war which restarted in 1983 has been a major contributing cause and continues to hinder provision of treatment, data collection and control measures. METHODS: Since the first of three clinics to treat VL was established in WUN in 1989, data on the epidemic and mortality have been collected in seven retrospective surveys of villages and among patients. Adults were interviewed about surviving family members and those who had died since the epidemic came. Survey death rates are used here to estimate mortality from VL and 'excess mortality' above expected levels. RESULTS: The surveys found high mortality at all ages and suggest an overall death rate of 38-57% since the epidemic started in 1984, and up to 70% in the most affected areas. Both methods of estimation suggest that around 100,000 deaths, among about 280,000 people in the epidemic area, might be attributable to VL. CONCLUSIONS: This continuing epidemic has shown that VL can cause high mortality in an outbreak with astonishingly high infection rates. Population movement has been a major factor in transmission and poor nutritional status has probably contributed to the risk of clinical infection. Although over 17,000 people have been successfully treated for VL at the clinics in WUN, the disease is likely to become endemic there.en
dc.language.isoenen
dc.publisherOxford University Pressen
dc.relation.urlhttp://ije.oxfordjournals.org/cgi/reprint/25/4/862.pdfen
dc.rightsArchived on this site with kind permission from Oxford University Press and the International Epidemiological Associationen
dc.subject.meshAdolescenten
dc.subject.meshAdulten
dc.subject.meshChilden
dc.subject.meshChild, Preschoolen
dc.subject.meshDisease Outbreaksen
dc.subject.meshEmigration and Immigrationen
dc.subject.meshFemaleen
dc.subject.meshHealth Services Accessibilityen
dc.subject.meshHumansen
dc.subject.meshInfanten
dc.subject.meshInfant, Newbornen
dc.subject.meshLeishmaniasis, Visceralen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshRetrospective Studiesen
dc.subject.meshRural Health Servicesen
dc.subject.meshStarvationen
dc.subject.meshSudanen
dc.subject.meshWaren
dc.titleThe epidemic of visceral leishmaniasis in western Upper Nile, southern Sudan: course and impact from 1984 to 1994.en
dc.contributor.departmentMSF (Médecins sans Frontières)-Holland, Amsterdam, The Netherlands.en
dc.identifier.journalInternational Journal of Epidemiologyen
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