Kala-azar in Ethiopia I: Leishmanin skin test in Setit Humera, a kala-azar endemic area in northwestern Ethiopia

Fuller, George K.; Lemma, Alemayehu; Haile, Trinidad; Atwood, C.L.

doi:10.1080/00034983.1976.11687108

Cited by 28 publications

(21 citation statements)

References 12 publications

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“…2 The lack of correlation of positivity rate with age, as is commonly observed in established endemic foci 15,16 (Table 1), suggests that there is no cumulative response to infection from historical exposures, and thus infection in the area is likely to be of recent origin. A similar association of Leishmania infection with farming practices, as indicated in our survey, has previously been reported by Fuller and others 17 in the Humera focus. It is interesting to note that there was large-scale expansion of agriculture in Humera then, as it is taking place in our study area now.…”

Section: Discussionsupporting

confidence: 68%

Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia: Reemerging or Emerging?

Abera

Tasew

Tsegaw

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. Kala-azar is a growing public health problem in Ethiopia. Benishangul-Gumuz regional state was previously not known to be endemic for the disease. In response to a case report from the region, we conducted a rapid assessment survey. A pretested questionnaire was used to capture sociodemographic and clinical histories pertinent to kala-azar. Study participants with complaints of fever and headache for 2 weeks or more were tested for kala-azar and malaria. All participants were screened with the leishmanin skin test and the direct agglutination test for exposure to Leishmania, defined as a positive result with either or both tests. Of 275 participants, 20 were exposed giving an overall leishmaniasis seroprevalence rate of 7.3%. Among the 20 positive individuals, 19 were farmers and nine of them reported no travel history outside their district. It appears that kala-azar is emerging in Dangur and Guba districts of Benishangul-Gumuz regional state, probably in connection with human encroachment into one or several previously out-of-reach zoonotic foci. We recommend integrated epidemiological surveys for confirmation and early containment of disease transmission in the area.

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Section: Discussionsupporting

confidence: 68%

Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia: Reemerging or Emerging?

Abera

Tasew

Tsegaw

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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“…For this reason, 300 000–500 000 highlanders migrate to the lowlands annually and they are the main risk group for the disease (Fuller et al . ; Alvar et al . , ).…”

Section: Introductionmentioning

confidence: 99%

Clinical aspects of paediatric visceral leishmaniasis in North‐west Ethiopia

Diro

Lynen

Gebregziabiher³

et al. 2014

Tropical Med Int Health

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Abstractobjective Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients.methods A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted.results A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5-12 years); 23% were under 5 years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow-up (80.2%).conclusion While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.

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“…The main vector on both sides of the border is Phlebotomus orientalis , found in association with cracked black cotton-clay soils and acacia-balanites forest [8], [9]. Hundreds of thousands of seasonal agricultural workers migrate into the Humera-Metema area each year, staying months to years and often living under precarious conditions, and VL occurs in both long-term residents and migrants [10], [11]. In this complex epidemiological setting, understanding risk factors for VL is crucial for the design of appropriate interventions.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Visceral Leishmaniasis among Residents and Migrants in Kafta-Humera, Ethiopia

et al. 2013

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BackgroundVisceral leishmaniasis is a lethal parasitic disease transmitted by phlebotomine sand flies. The largest focus of VL in Ethiopia is located in the lowland region bordering Sudan, where the epidemiology is complicated by the presence of thousands of seasonal agricultural workers who live under precarious conditions.Methodology/Principal FindingsWe conducted two parallel case-control studies to identify factors associated with VL risk in residents and migrants. The studies were conducted from 2009 to 2011 and included 151 resident cases and 157 migrant cases, with 2 matched controls per case. In multivariable conditional regression models, sleeping under an acacia tree at night (odds ratios (OR) 5.2 [95% confidence interval 1.7–16.4] for residents and 4.7 [1.9–12.0] for migrants), indicators of poverty and lower educational status were associated with increased risk in both populations. Strong protective effects were observed for bed net use (OR 0.24 [0.12–0.48] for net use in the rainy season among residents, OR 0.20 [0.10–0.42] for any net use among migrants). For residents, living in a house with thatch walls conferred 5-fold and sleeping on the ground 3-fold increased risk. Among migrants, the risk associated with HIV status was borderline significant and sleeping near dogs was associated with 7-fold increased risk.Conclusions/SignificancePreventive strategies should focus on ways to ensure net usage, especially among migrant workers without fixed shelters. More research is needed to understand migration patterns of seasonal labourers and vector bionomics.

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Kala-azar in Ethiopia I: Leishmanin skin test in Setit Humera, a kala-azar endemic area in northwestern Ethiopia

Cited by 28 publications

References 12 publications

Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia: Reemerging or Emerging?

Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia: Reemerging or Emerging?

Clinical aspects of paediatric visceral leishmaniasis in North‐west Ethiopia

Risk Factors for Visceral Leishmaniasis among Residents and Migrants in Kafta-Humera, Ethiopia

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