Burden and risk factors of cutaneous leishmaniasis in a peri-urban settlement in Kenya, 2016

Ngere, Isaac; Boru, Waqo; Isack, Abdikadir; Muiruri, Joshua; Obonyo, Mark; Matendechero, Sultani; Gura, Zeinab

doi:10.1371/journal.pone.0227697

Cited by 29 publications

(44 citation statements)

References 19 publications

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“…Generally, the problem of peri-urban residents has been overlooked in the mainstream delivery of not only PHC services globally [ 54 ] but also essentials for standards of living. The peri-urban settlement adjacent to the city of Kerman has become a newly emerging ACL focus and an important concern in the epidemiology of ACL.…”

Section: Discussionmentioning

confidence: 99%

A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor

et al. 2021

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Background Epidemics of cutaneous leishmaniasis (CL) are occurring more frequently and spreading faster and farther than before in many areas of the world. The present study aimed to assess a long-lasting emerging epidemic (2005–2019) of 5532 cases with anthroponotic CL (ACL) in peri-urban areas of Kerman city in southeastern Iran. Methods This descriptive-analytical study was carried out for 15 years in Kerman province, southeastern Iran. The data were passively obtained through the health surveillance system and the Kerman Leishmaniasis Research Center. Every subject was diagnosed using direct smear microscopy. The representative causative agent was further examined by ITS1-PCR, PCR-RFLP, 7SL RNA gene sequencing and phylogenetic analyses. For each subject, a case report form designating demographic and clinical data was recorded. Results A different pattern of ACL incidence was found in peri-urban areas compared to that in the city of Kerman. The incidence rate of ACL cases has significantly increased (P < 0.001) from 2005 to 2016 in new settlements with a gradual decline after that. The overall average risk of contracting the disease was 7.6 times higher in peri-urban areas compared to Kerman city, an old endemic focus. All isolates consisting of six variants were confirmed to be Leishmania tropica. The overall pattern of the ACL infection indicates that the etiological agent of ACL is propagated and transmitted by the bite of female Phlebotomus sergenti sandflies from person to person from dissimilar clones as reflected by the complexity of the migrants’ backgrounds in the province. Conclusions The movement of populations and establishment of new settlements in peri-urban areas close to endemic areas are major risk factors for and are directly linked to CL. The underlying factors of this emerging ACL epidemic caused by L. tropica were disasters and droughts, among others. A robust commitment to a multilateral approach is crucial to make improvements in this area. This will require decisive coordinated actions through all governmental factions and non-governmental organizations. Furthermore, active and passive case detection strategies, early diagnosis, and effective treatment could help control the disease.

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Section: Discussionmentioning

confidence: 99%

A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor

et al. 2021

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“…Leishmaniasis is a parasitic disease that is found in parts of the tropics, subtropics, and southern Europe. It is caused by infection with Leishmania parasites, which are spread by the bite of infected sand flies [ 1 , 2 ]. There are different forms of leishmaniasis.…”

Section: Introductionmentioning

confidence: 99%

Cutaneous Leishmaniasis Outbreak Investigation in Hajjah Governorate, Yemen, in 2018: Case-Control Study

Nassar¹,

Abdelrazzaq²,

Almahaqri³

et al. 2021

JMIR Public Health Surveill

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Background Cutaneous leishmaniasis (CL) is endemic in Yemen. About 4440 cases were reported in 2019. On July 23, 2018, a Hajjah governorate surveillance officer notified the Ministry of Public Health and Population about an increase in the number of CL cases in Bani-Oshb, Kuhlan district, Hajjah governorate. On July 24, 2018, Yemen Field Epidemiology Training Program sent a team to perform an investigation. Objective We aimed to describe a CL outbreak in Hajjah governorate and determine its risk factors. Methods A descriptive study and case-control study (1:1 ratio) were conducted. Cases included people who met the suspected or confirmed case definition of the World Health Organization and lived in Bani-Oshb subdistrict during the period from August 2017 to July 2018. Controls included people living for at least 1 year in Bani-Oshb without new or old skin lesions. Crude odds ratios (cORs) and adjusted odds ratios (aORs) with 95% CI were used to test the significance of associations. Results We identified 30 CL cases. Among the 30 patients, 7 (23%) were younger than 5 years, 17 (57%) were 5 to 14 years, 17 (57%) were females, and 23 (77%) had one lesion. The attack rate was 7 per 1000 population in the age group <15 years and 1 per 1000 population in the age group ≥15 years. On bivariate analysis, the following factors were significantly associated with CL: female gender (cOR 5.2, 95% CI 1.7-16.5), malnutrition (cOR 5.2, 95% CI 1.7-16.5), not using a bed net (cOR 14.5, 95% CI 1.7-122.4), poor house lighting (cOR 6.4, 95% CI 2.1-19.7), poor house hygiene (cOR 11.2, 95% CI 3.1-40.7), poor sanitation (cOR 14.5, 95% CI 1.7-122.4), living in houses without window nets (cOR 5.2, 95% CI 1.3-21.2), plantation around the house (cOR 6.5, 95% CI 2.1-20.5), animal barn inside or close to the house (cOR 9.3, 95% CI 1.9-46.7), raising animals (cOR 8.1, 95% CI 1.6-40.7), and having animal dung in or near the house (cOR 6.8, 95% CI 1.7-27.7). The following risk factors remained significant on multivariate stepwise analysis: female gender (aOR 22.7, 95% CI 1.6-320.5), malnutrition (aOR 17.2, 95% CI 1.3-225.8), poor house hygiene (aOR 45.6, 95% CI 2.5-846.4), plantation around the house (aOR 43.8, 95% CI 1.9-1009.9), and raising animals (aOR 287.1, 95% CI 5.4-15205.6). Conclusions CL was endemic in Hajjah governorate, and an increase in cases was confirmed. Many individual, housing, and animal related factors were shown to contribute to CL endemicity. Implementation of control measures directed toward altering the factors favoring contact among vectors, reservoirs, and susceptible humans is strongly recommended to control future outbreaks.

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“…In Kenya, the cutaneous form of the disease is deemed endemic by the WHO, however there are a lack of accurate data describing the true extent of disease or case numbers ( 85 , 86 ). CL was first documented in 1969 and is caused by: L. tropica , predominantly found centrally and in the Rift Valley; L. major , reported in the lowlands of Kitui and Baringo ( 38 , 82 , 87 ); and L. aethiopica , detected in areas of high altitudes such as Mount Elgon ( 88 ).…”

Section: Kenyamentioning

confidence: 99%

Leishmaniasis Beyond East Africa

Jones

Welburn

2021

Front. Vet. Sci.

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Climate change is having a substantial impact on our environment and ecosystems and has altered the way humans live, access, and utilize resources with increased risk of zoonotic infectious disease encounters. As global temperatures continue to increase, they impact on public health, migration, food security and land conflict, and as new environments become favorable, exposure to disease carrying vectors. Increased forests or natural habitat clearance for land repurposing, urbanization, road building, and water management are related to an increase in emerging vector borne parasitic diseases. The East African region remains one of the most impacted regions globally for leishmaniasis, a vector borne disease that impacts significantly on the health, wellbeing and livelihoods of affected communities and for which a lack of reporting and control interventions hinder progress toward elimination of this neglected tropical disease. As our world continues to transform, both politically and climatically, it is essential that measures are put in place to improve surveillance and disease management with implementation of control measures, including vector control, especially in low- and middle-income countries that are expected to be most impacted by changes in climate. Only through effective management, now, can we be sufficiently resilient to preventing the inevitable spread of vectors into suitable habitat and expansion of the geographical range of leishmaniasis. This review offers a current perspective on Leishmaniasis as an endemic disease in East Africa and examines the potential of the recent emergence of Leishmania infection in hitherto unaffected regions to become a public health concern if no disease management is achieved.

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Burden and risk factors of cutaneous leishmaniasis in a peri-urban settlement in Kenya, 2016

Cited by 29 publications

References 19 publications

A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor

A long-lasting emerging epidemic of anthroponotic cutaneous leishmaniasis in southeastern Iran: population movement and peri-urban settlements as a major risk factor

Cutaneous Leishmaniasis Outbreak Investigation in Hajjah Governorate, Yemen, in 2018: Case-Control Study

Leishmaniasis Beyond East Africa

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