02961nas a2200481   4500000000100000008004100001653000900042653001500051653001200066653002500078653001100103653001000114653002000124653001100144653001100155653001700166653001000183653002400193653001800217653001300235653001500248653002000263653000900283653002600292653003100318653001600349653001200365653001700377653001100394100001900405700001700424700001200441700001300453700001500466700001800481700001400499245012000513856007600633300001100709490000700720520173800727022001402465       2008                            d10aNTDs10aAdolescent10aAnimals10aCase-Control Studies10aCattle10aChild10aDisease Vectors10aFemale10aHumans10aInsecticides10aKenya10aLeishmania donovani10aLeishmaniasis10aVisceral10aLife Style10aLogistic Models10aMale10aMultivariate Analysis10aPatient Education as Topic10aPhlebotomus10aPoverty10aRisk Factors10aUganda1 aKolaczinski JH1 aReithinger R1 aWorku D1 aOcheng A1 aKasimiro J1 aKabatereine N1 aBrooker S00aRisk factors of visceral leishmaniasis in East Africa: a case-control study in Pokot territory of Kenya and Uganda.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2637948/pdf/ukmss-3796.pdf  a344-520 v373 a<p><strong>BACKGROUND: </strong>In East Africa, visceral leishmaniasis (VL) is endemic in parts of Sudan, Ethiopia, Somalia, Kenya and Uganda. It is caused by Leishmania donovani and transmitted by the sandfly vector Phlebotomus martini. In the Pokot focus, reaching from western Kenya into eastern Uganda, formulation of a prevention strategy has been hindered by the lack of knowledge on VL risk factors as well as by lack of support from health sector donors. The present study was conducted to establish the necessary evidence-base and to stimulate interest in supporting the control of this neglected tropical disease in Uganda and Kenya.</p>

<p><strong>METHODS: </strong>A case-control study was carried out from June to December 2006. Cases were recruited at Amudat hospital, Nakapiripirit district, Uganda, after clinical and parasitological confirmation of symptomatic VL infection. Controls were individuals that tested negative using a rK39 antigen-based dipstick, which were recruited at random from the same communities as the cases. Data were analysed using conditional logistic regression.</p>

<p><strong>RESULTS: </strong>Ninety-three cases and 226 controls were recruited into the study. Multivariate analysis identified low socio-economic status and treating livestock with insecticide as risk factors for VL. Sleeping near animals, owning a mosquito net and knowing about VL symptoms were associated with a reduced risk of VL.</p>

<p><strong>CONCLUSIONS: </strong>VL affects the poorest of the poor of the Pokot tribe. Distribution of insecticide-treated mosquito nets combined with dissemination of culturally appropriate behaviour-change education is likely to be an effective prevention strategy.</p>
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