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


Autoři: Isaac Ngere aff001;  Waqo Gufu Boru aff002;  Abdikadir Isack aff002;  Joshua Muiruri aff002;  Mark Obonyo aff002;  Sultani Matendechero aff003;  Zeinab Gura aff002
Působiště autorů: Global Health Program-Kenya, Washington State University, Nairobi, Kenya aff001;  Field Epidemiology and Laboratory Training Program, Nairobi, Kenya aff002;  Ministry of Health, Nairobi, Republic of Kenya aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227697

Souhrn

Background

Cutaneous leishmaniasis is a neglected disease known to cause significant morbidity among the poor. We investigated a suspected outbreak to determine the magnitude of cases, characterize the cases and identify risk factors of cutaneous leishmaniasis in Gilgil, a peri-urban settlement in Central Kenya.

Methods

Hospital records for the period 2010–2016 were reviewed and additional cases were identified through active case search. Clinical diagnosis of cutaneous leishmaniasis was made based on presence of ulcerative, nodular or papular skin lesion. The study enrolled 58 cases matched by age and neighbourhood to 116 controls in a case control study. Data was collected using structured questionnaires and simple proportions, means and medians were computed, and logistic regression models were constructed for analysis of individual, indoor and outdoor risk factors.

Results

Of the 255 suspected cases of cutaneous leishmaniasis identified, females constituted 56% (142/255) and the median age was 7 years (IQR 7–21). Cases occurred in clusters and up to 43% of cases originated from Gitare (73/255) and Kambi-Turkana (36/255) villages. A continuous transmission pattern was depicted throughout the period under review. Individual risk factors included staying outside the residence in the evening after sunset (OR 4.1, CI 1.2–16.2) and visiting forests (OR 4.56, CI 2.04–10.22). Sharing residence with a case (OR 14.4, CI 3.8–79.3), residing in a thatched house (OR 7.9, CI 1.9–45.7) and cracked walls (OR 2.3, CI 1.0–4.9) were identified among indoor factors while sighting rock hyraxes near residence (OR 5.3, CI 2.2–12.7), residing near a forest (OR 7.8, CI 2.8–26.4) and having a close neighbour with cutaneous leishmaniasis (OR 6.8, CI 2.8–16.0) were identified among outdoor factors.

Conclusions

We identify a large burden of cutaneous leishmaniasis in Gilgil with evidence of individual, indoor and outdoor factors of disease spread. The role of environmental factors and rodents in disease transmission should be investigated further

Klíčová slova:

Forests – Leishmaniasis – Lesions – Medical risk factors – Ulcers – Valleys – Skin diseases – Hyraxes


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