Abstract
Leishmaniasis is a disease caused by protozoan parasites of the genus Leishmania. Visceral leishmaniasis (VL) affects many people in some parts of Ethiopia, with occasional outbreaks. Community participation and disease trends are of paramount importance in the control of infectious diseases, including VL. The aim of this study was to assess the knowledge, attitude and practice related to VL in four endemic kebeles (sub-districts) of Libo Kemkem wereda (district), Northwest Ethiopia, and to determine the trend of VL in the same district in the last fourteen years (April 2005- December 2018). In order to assess the knowledge, attitude and practice (KAP) related to VL, a community-based cross-sectional study was conducted in four endemic kebeles of Libo Kemkem woreda, Northwest Ethiopia. Three hundred ninety-eight (398) study participants (200 males and 198 females) were selected by systematic random sampling and questionnaires were used to collect data. A retrospective study was done to determine the trend of VL in Libo Kemkem woreda in the past fourteen years (April 2005-December 2018) using data collected from patients’ registration book at the Addis zemen hospital and local health centers. The results from the questionnaire survey revealed that 97.7% of the respondents heard about VL before, but only 12.8% and 5.3% knew the etiologic agent and the vector of the disease, respectively. Nearly all respondents (97.2%) believed that health education is necessary to minimize the challenges of the disease. Close to half (44.5%) of the respondents believed that a complete cure of the disease is possible. Approximately 88% of the respondents did not practice anything to protect themselves from the Sand fly bite. The occurrence of VL in Libo Kemkem wereda decreased from 2005 to 2008 and then gradually increased in the next five years (2008 to 2013) and slightly decreased over the last five years (2013-2018). The disease spread to 27 kebeles (subdistricts) in recent years. The overall study revealed that the local societies have a low level of knowledge, attitude, and practice related to VL. VL showed a little decreasing trend over the recent consecutive years. Hence, educating the local community about VL and mobilizing them to take preventive measures is crucial in effective control of VL in the study area.
Highlights
Species of the genus Leishmania (Kinetoplastida, Trypanosomatidae) cause leishmaniasis and are usually transmitted between vertebrate hosts by the bite of blood sucking female sandflies (Diptera, Psychodidae) [1]
The present study was conducted in Bura Egzi Abhier Ab, Shina Tsion, Yifag Town and Angot kebele, which are located in Libo Kemkem Woreda, South Gondar Zone, Amhara Regional State, Northwest Ethiopia (Figure 1)
Health records of Visceral leishmaniasis (VL) and patient registration books obtained from Addis Zemen hospital and Addis Zemen health center showed that the incidence of VL in the study area decreased steadily from 2006 to 2008, gradually increased to five years (2008 to 2013) and decrease in the last three years (Figure 2). This gradual decrement of VL result is in agreement with the studies conducted Humera town, Ethiopia and Eastern Sudan, where the results showed that leishmaniasis cases decreased across the study years with the highest recorded in 2014 and There was a clear decline in the cumulative case and fatality rate from the year 2002 to the year 2015 respectively [12, 13]
Summary
Species of the genus Leishmania (Kinetoplastida, Trypanosomatidae) cause leishmaniasis and are usually transmitted between vertebrate hosts by the bite of blood sucking female sandflies (Diptera, Psychodidae) [1]. The disease is categorized into cutaneous, mucosal and visceral leishmaniasis. Diagnose is and treatment of the disease is difficult and about 95% of VL patients are likely to die if left untreated. International Journal of Infectious Diseases and Therapy 2019; 4(2): 23-28. Wild animals and domestic dogs are known to serve as reservoir hosts. Its generalized clinical syndrome involves the reticulo-endothelial system infection (spleen, bone marrow, and liver), weight loss and anemia. Leishmanias is mainly affecting the poor, those with vulnerable housing and environmental conditions. Loss of income and health care costs exacerbate the economic situation of already disadvantaged households [3]
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