Abstract
BackgroundImproving knowledge on local determinants of visceral leishmaniasis (VL) is crucial to guide the development of relevant control strategies. This study aimed to identify individual and household level determinants of primary VL in 24 highly endemic villages of Tabarak Allah hospital’s catchment area, Gedaref State, Sudan.MethodsFrom September 2012 to July 2013, in an unmatched case-control design, 198 patients with primary VL were compared to 801 controls free of VL symptoms and with a negative VL rapid test. Using random spatial sampling, controls were selected with a distribution of age, sex and village of residence proportionate to the distribution of the target population. Data were collected using a structured questionnaire.ResultsChildren and men were at higher risk of VL. Reporting VL patient(s) in the household in the previous year was the strongest VL risk factor. In a multivariate analysis, VL risk increased with household size, sleep location (outside the yard, not in the farm), evening outdoor activities in the rainy season (playing, watching TV, radio listening), use of ground nut oil as animal repellent and of smoke of Acacia seyal as indoor repellent, presence of dogs in the yard at night, Acacia nilotica in the yard’s immediate surroundings and of a forest at eye range. VL risk appeared to decrease with the use of drinking water sources other than the village water tank, a buffer distance from the adjacent house yard, and with the presence of animals other than dogs in the yard at night. In contrast with previous studies, housing factors, mosquito-net use, black cotton soil, ethnicity, socioeconomic index, presence of Balanites aegyptica and Azadirachta indica in the yard were not independent VL determinants.Discussion and conclusionAlthough these results do not provide evidence of causality, they provide useful suggestions for guiding further intervention studies on VL preventive measures.
Highlights
Visceral leishmaniasis (VL) is a devastating illness with a high case fatality rate when left untreated
VL risk increased with household size, sleep location, evening outdoor activities in the rainy season, use of ground nut oil as animal repellent and of smoke of Acacia seyal as indoor repellent, presence of dogs in the yard at night, Acacia nilotica in the yard’s immediate surroundings and of a forest at eye range
In Sudan, there is a lack of knowledge on VL risk and protective factors, limiting the possibility of development of control strategies
Summary
Visceral leishmaniasis (VL) is a devastating illness with a high case fatality rate when left untreated. Gedaref state is the main endemic area of VL in Sudan where the detection figures vary largely between villages in relation with average rainfall and altitude [1]. In Eastern Sudan, VL is caused by the parasite Leishmania donovani and transmitted through the sandfly Phlebotomus orientalis [2,3]. Especially dogs [6], have been shown infected by L. donovani in eastern Africa, their role in transmission is unclear and the disease is believed to be mainly anthroponotic [7,8]. This study aimed to identify individual and household level determinants of primary VL in 24 highly endemic villages of Tabarak Allah hospital’s catchment area, Gedaref State, Sudan
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
