Prevalence, associated factors, and outcomes of visceral shmania infection in Moroto district; a cross-sectional study.

Abstract

Introduction: Visceral leishmaniasis (VL) remains one of the neglected tropical diseases (NTD) of public health importance. The condition remains poorly studied for instance, the contribution of admissions from Moroto district to Amudat Hospital may not reflect the burden, magnitude and true picture of the condition in Moroto District. No previous studies have described prevalence, associated factors and outcomes of VL in Moroto District. Moreover, given its geographic and ethnic preponderance, data remains incomplete in Moroto District. The overarching aim for this study is to describe prevalence, risk factors and outcomes in Moroto District as an initial step to understanding the condition in these settings and as a contribution to the VL map in the region and country. Methods: We conducted a cross-sectional study in which community cases were identified amongst the 288 individuals sampled at baseline. They were followed up at Amudat hospital Kala azar treatment centre for treatment outcome. At baseline, information relating to demographic, socioeconomic and anthropometric data of participants was captured using an interviewer-administered structured questionnaire. Prevalence and factors associated with VL infection at baseline were determined. Chi-square was the test statistic and logistic regression analysis was done with clustering being factored in at county level. At follow up stage, the outcomes were determined.

Results: The overall prevalence of VL infection in Moroto district was found to be 5.21% (95%CI:3.15% - 8.48%), Matheniko county having the highest prevalence of 6.90%, followed by Tepeth county at 4.49% and Moroto Municipality with the lowest prevalence of 3.61%. From the results, the high-risk factor for VL infection in Moroto district included; - incorrect knowledge of habitat for Sand flies (AOR 5.33 (95%CI: (1.69-16.82). The signs and symptoms of VL disease included: fever, headache, abdominal pain and swelling, coughing, night sweats, diarrhea, fatigue, breathlessness and nose bleeding. The average hospitalization for VL was 17 days. All the patients who were treated at the hospital cured.

Conclusion and Recommendation: This neglected tropical disease is still prevalent in Moroto district, with a prevalence of 5.21 %. The high-risk factors for VL infection included lack of knowledge about the habitat for Sand flies. The outcome for VL infection were; - hospitalization of not more than 17 days, and all the treated patients cured. The prevalence of 5.2 % in Moroto district is within the scope for elimination proportion and therefore, the Ministry of Health should start elimination activities so as to prevent this from escalating into a public health problem.