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Determinants of Visceral Leishmaniasis: A Case-Control Study in Gedaref State, Sudan | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Determinants of Visceral Leishmaniasis: A Case-Control Study in Gedaref State, Sudan

Nackers F, Mueller YK, Salih NA, Elhaq MS, Elbadawi ME, Hammam O, Mumina A, Atia AM, Etard JF, Ritmeijer KKD, Chappuis F
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Abstract
BACKGROUND
Improving 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.

METHODS
From 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.

RESULTS
Children 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 CONCLUSION
Although these results do not provide evidence of causality, they provide useful suggestions for guiding further intervention studies on VL preventive measures.

Countries

Sudan

Subject Area

kala azar

Languages

English
DOI
10.1371/journal.pntd.0004187
Published Date
06 Nov 2015
PubMed ID
26544177
Journal
PLOS Neglected Tropical Diseases
Volume | Issue | Pages
Volume 9, Issue 11, Pages e0004187
Issue Date
2015-11-06
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