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Visceral leishmaniasis (VL) is a vector-borne disease highly influenced by environmental factors. A model was developed for mapping the distribution and incidence of VL in Gedaref State, eastern Sudan, in relation to different environmental factors. Geographical information systems (GIS) were used to extract and map regression results for environmental variables of 190 villages in Gedaref State, including rainfall, vegetation status, soil type, altitude, distance from river, topography, wetness indexes, and average rainfall estimates. VL incidence in each village was calculated from hospital records. By use of logistic and linear multivariate regression analyses, models were developed to determine which environmental factors explain variability in VL presence and incidence. We found that average rainfall and the altitude were the best predictors of VL incidence. The resulting models were mapped by GIS software predicting both VL presence or absence and incidence at any locality in Gedaref State. The results are discussed in relation to VL control.
Received July 13, 2001. Accepted for publication December 3, 2001.
Acknowledgments: We thank Khartoum Office of MSF-Holland and the Ministry of Health of Gedaref State for giving us the permission to analyze and publish their hospital record data. Thanks are due to Dr. Fathi M. Elraba’a, Dr. M. A. Kambal, Dr. S. Abukashawa, Dr. O. F. Osman (Faculty of Science, University of Khartoum), Prof. A. M. El Hassan, and Dr. Ibrahim M. El Hassan (Institute of Endemic Diseases, Univeristy of Khartoum), and Dr. H. Giha (Department of Biochemistry, University of Khartoum) for their help and support.
Financial support: This work was supported by funds from EMRO-Office of World Health Organization (WHO T5/72/6, grant SGS00/ 55), a Shell fellowship from the Liverpool School of Tropical Medicine (D.-E.A.E.) and the Dempster Memorial Trust Fund (M.M.T.).
Reprint requests: Madeleine C. Thomson, International Research Institute for Climate Prediction (IRI), Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York, 10964, Telephone: 845-680-4413, Fax: 845-680-4866, E-mail: mthomson{at}iri.columbia.edu. Dia-Eldin A. Elnaiem, Department of Zoology, Faculty of Science, University of Khartoum, Khartoum, P.O. Box 321, Sudan, E-mail: dialnaiem{at}hotmail.com
Authors’ addresses: Dia-Eldin A. Elnaiem and Abdelrafie M. Mekkawi, Department of Zoology, Faculty of Science, University of Khartoum, Sudan. Judith Schorscher, MSF-Holland, Maison Porpi-gna, 64260 Buzy, France. Anna Bendall, University of Greenwich, Chatham, United Kingdom. Valérie Obsomer, Stephen J. Connor, Richard W. Ashford, and Madeleine C. Thomson, Liverpool School of Tropical Medicine, Liverpool, United Kingdom. Maha E. Osman, Institute of Biotechnology, National Centre for Research, Sudan.
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