Factors associated with visceral leishmaniasis infection in North Gondar zone, Amhara Region, North West Ethiopia

Abstract

Background: Leishmaniasis is becoming a major public health problem both in terms of geographical spread and incidence. Visceral leishmaniasis, the worst form among its clinical forms, is the second largest cause of parasite related death responsible for 500,000 new cases each year. No or few risk factor data is available in North Gondar zone on this deadly disease. Objective: To assess determinants of visceral leishmaniasis in north Gondar Zone, North West Ethiopia. Methods: Facility based unmatched case-control study was employed from September 1-30, 2013. Samples of 545 case control pairs were included using consecutive sampling technique. Data was collected using pretested structured questionnaire; entered into EpiData version 3.1 and exported to SPSS version 16.0 for analysis. Crude and adjusted odds ratio with 95% CI was calculated to determine the strength of association between response and predictor variables. P- value less than 0.05 was considered as a level of significance. Result: Male sex (OR=4.64; 95%CI=2.29, 9.39) and age below 15 years (OR=3.26; 95%CI=1.54, 6.92) were positively associated with visceral leishmaniasis infection. Mud wall (OR= 2.49; 95%CI=1.12, 5.58), presences of dog (OR=4.41; 95%CI= 2.25, 8.62), termite hills (OR=3.04; 95%CI=1.59, 5.81) and acacia trees (OR=3.19; 95%CI=1.70, 5.99) increased the risk of infection. Outdoor sleeping (OR=6.28; 95%CI= 3.41, 11.55) was also associated with higher risk of infection. HIV infection (OR=3.28; 95%CI=1.45, 7.39) and malnutrition (OR=2.92; 95%CI=1.55, 5.51) were associated with higher risk of infection. Conclusion: Male genders and being below 15 years of age were positive socio-demographic determinants of visceral leishmaniasis. House made with mud wall was among the associated factors. Presence of dog, termite hills and acacia trees were also important risk factors. Outdoor sleeping was positively associated with visceral leishmaniasis. HIV and malnutrition were also important predictors of the disease. Therefore, the risk of infection can be reduced by improving housing condition, sleeping indoor above ground, making residential area free and far from termite hills and acacia tree. The role of peri-domestic animals should also be investigated.