Risk factors of visceral leishmaniasis in East Africa: a case-control study in Pokot territory of Kenya and Uganda

Hdl Handle:
http://hdl.handle.net/10144/30093
Title:
Risk factors of visceral leishmaniasis in East Africa: a case-control study in Pokot territory of Kenya and Uganda
Authors:
Kolaczinski, J H; Reithinger, R; Worku, D; Ocheng, A; Kasimiro, J; Kabatereine, N; Brooker, S
Journal:
International Journal of Epidemiology
Abstract:
BACKGROUND: In East Africa, visceral leishmaniasis (VL) is endemic in parts of Sudan, Ethiopia, Somalia, Kenya and Uganda. It is caused by Leishmania donovani and transmitted by the sandfly vector Phlebotomus martini. In the Pokot focus, reaching from western Kenya into eastern Uganda, formulation of a prevention strategy has been hindered by the lack of knowledge on VL risk factors as well as by lack of support from health sector donors. The present study was conducted to establish the necessary evidence-base and to stimulate interest in supporting the control of this neglected tropical disease in Uganda and Kenya. METHODS: A case-control study was carried out from June to December 2006. Cases were recruited at Amudat hospital, Nakapiripirit district, Uganda, after clinical and parasitological confirmation of symptomatic VL infection. Controls were individuals that tested negative using a rK39 antigen-based dipstick, which were recruited at random from the same communities as the cases. Data were analysed using conditional logistic regression. RESULTS: Ninety-three cases and 226 controls were recruited into the study. Multivariate analysis identified low socio-economic status and treating livestock with insecticide as risk factors for VL. Sleeping near animals, owning a mosquito net and knowing about VL symptoms were associated with a reduced risk of VL. CONCLUSIONS: VL affects the poorest of the poor of the Pokot tribe. Distribution of insecticide-treated mosquito nets combined with dissemination of culturally appropriate behaviour-change education is likely to be an effective prevention strategy.
Affiliation:
Malaria Consortium Africa, Kampala, Uganda. Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London UK. Clinical Trials Area, Westat, Rockville, MD, USA. Médecins Sans Frontières, Geneva, Switzerland. Vector Control Division, Ministry of Health, Kampala, Uganda.
Issue Date:
9-Jan-2008
URI:
http://hdl.handle.net/10144/30093
DOI:
10.1093/ije/dym275
PubMed ID:
18184669
Additional Links:
http://ije.oxfordjournals.org/cgi/content/abstract/dym275v1
Submitted date:
2008-06-13
Type:
Article
Language:
en
ISSN:
1464-3685
Appears in Collections:
Leishmaniasis/Kala Azar

Full metadata record

DC FieldValue Language
dc.contributor.authorKolaczinski, J H-
dc.contributor.authorReithinger, R-
dc.contributor.authorWorku, D-
dc.contributor.authorOcheng, A-
dc.contributor.authorKasimiro, J-
dc.contributor.authorKabatereine, N-
dc.contributor.authorBrooker, S-
dc.date.accessioned2008-06-17T11:36:33Z-
dc.date.available2008-06-17T11:36:33Z-
dc.date.issued2008-01-09-
dc.date.submitted2008-06-13-
dc.identifier.citationInt J Epidemiol 2008;37(2):344-52en
dc.identifier.issn1464-3685-
dc.identifier.pmid18184669-
dc.identifier.doi10.1093/ije/dym275-
dc.identifier.urihttp://hdl.handle.net/10144/30093-
dc.description.abstractBACKGROUND: In East Africa, visceral leishmaniasis (VL) is endemic in parts of Sudan, Ethiopia, Somalia, Kenya and Uganda. It is caused by Leishmania donovani and transmitted by the sandfly vector Phlebotomus martini. In the Pokot focus, reaching from western Kenya into eastern Uganda, formulation of a prevention strategy has been hindered by the lack of knowledge on VL risk factors as well as by lack of support from health sector donors. The present study was conducted to establish the necessary evidence-base and to stimulate interest in supporting the control of this neglected tropical disease in Uganda and Kenya. METHODS: A case-control study was carried out from June to December 2006. Cases were recruited at Amudat hospital, Nakapiripirit district, Uganda, after clinical and parasitological confirmation of symptomatic VL infection. Controls were individuals that tested negative using a rK39 antigen-based dipstick, which were recruited at random from the same communities as the cases. Data were analysed using conditional logistic regression. RESULTS: Ninety-three cases and 226 controls were recruited into the study. Multivariate analysis identified low socio-economic status and treating livestock with insecticide as risk factors for VL. Sleeping near animals, owning a mosquito net and knowing about VL symptoms were associated with a reduced risk of VL. CONCLUSIONS: VL affects the poorest of the poor of the Pokot tribe. Distribution of insecticide-treated mosquito nets combined with dissemination of culturally appropriate behaviour-change education is likely to be an effective prevention strategy.en
dc.language.isoenen
dc.relation.urlhttp://ije.oxfordjournals.org/cgi/content/abstract/dym275v1en
dc.rightsPublished by Oxford University Press. Archived on this site with kind permission from Oxford University Press and the International Epidemiological Associationen
dc.subject.meshLeishmaniasis, Visceralen
dc.subject.meshKenyaen
dc.subject.meshUgandaen
dc.titleRisk factors of visceral leishmaniasis in East Africa: a case-control study in Pokot territory of Kenya and Ugandaen
dc.typeArticleen
dc.contributor.departmentMalaria Consortium Africa, Kampala, Uganda. Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London UK. Clinical Trials Area, Westat, Rockville, MD, USA. Médecins Sans Frontières, Geneva, Switzerland. Vector Control Division, Ministry of Health, Kampala, Uganda.en
dc.identifier.journalInternational Journal of Epidemiologyen

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