Epidemiological investigation of Cutaneous Leishmaniasis in Sodo District Southern Ethiopia

Abstract

In Ethiopia, Cutaneous Leishmaniasis (CL) is a common infectious disease. However, existing knowledge on prevalence, risk factors, community awareness and circulating parasite species are scarce. The study aimed at producing evidence to inform prevention strategies through epidemiological study using different approaches. Objectives are to access knowledge, attitude, and practices about CL, investigate risks related to transmission and determine prevalence of CL in Sodo District. Primary quantitative method using a cross-sectional descriptive approach was applied. Data were collected from interviews held with 423 households for the KAP survey. In factor assessment and prevalence study, 379 households harbouring 1356 individuals were interviewed along with clinical assessment. In the KAP study, 263 (61.9%), 226 (53.4%), and 213 (50.4%) have satisfactory knowledge, favourable attitude, and good practice about leishmaniasis. Majority are unable to identify leishmaniasis and unaware of its cause and transmission, respectively. Sandfly is considered "important biting and blood-sucking insect" by 210 (49.6%) but knowledge on biting time and breeding place was unsatisfactory. Most believed CL can be treated, is a serious problem and have a disfiguring outcome. However, most (59.3%, n=251) prefer use of traditional medication. Concerning practice, 288 (68.1%) have bed nets but personal protective measures are rarely used. Risk factor assessment shows kebele, presence of screen on window/door, sensel tree and cave/gorge, host factors (travel history, sleeping at home yard, irrigating at night, spending time near cave/gorge, using personal protective measures and sleeping hand/face covered), hyrax near home and dumping dung to be significant factors affecting leishmaniasis. Prevalence of leishmaniasis was 9.07% (123/1,356) for both scars (5.45%) and active (3.61%) infection. Lesions were mainly located on face parts and LCL was the most common form. The PCR test identified Leishmania aethiopica as principal species. The Sodo community will benefit from awareness creation programs cause, transmission, and vector of leishmaniasis. Prevention programmes should prioritise changes in host behavior such as putting a screen on window or door, use of personal protective measures, irrigation at night, and sleeping covering hand and face. CL is a challenging public health crisis in the district and due attention needs to be given to it.