• 1

    Alvar J, Bashaye S, Argaw D, Cruz I, Aparicio P, Kassa A, Orfanos G, Parreno F, Babaniyi O, Gudeta N, Canavate C, Bern C, 2007. Kala-azar outbreak in Libo Kemkem, Ethiopia: epidemiologic and parasitologic assessment. Am J Trop Med Hyg 77 :275–282.

    • Search Google Scholar
    • Export Citation
  • 2

    Ashford RW, Hutchinson MP, Bray RS, 1973. Kala-azar in Ethiopia: epidemiological studies in a highland valley. Ethiop Med J 11 :259–264.

    • Search Google Scholar
    • Export Citation
  • 3

    Mengesha B, Abuhoy M, 1978. Kala-azar among labour migrants in Metema-Humera region of Ethiopia. Trop Geogr Med 30 :199–206.

  • 4

    Bashaye S, Nombela N, Argaw D, Mulugeta A, Herrero M, Nieto J, Chicharro C, Cañavate C, Aparicio P, Vélez ID, Alvar J, Bern C, 2009. Risk factors for visceral leishmaniasis in a new epidemic site in Amhara region, Ethiopia. Am J Trop Med Hyg 81 :34–39.

    • Search Google Scholar
    • Export Citation
  • 5

    World Health Organization Department of Communicable Disease Surveillance and Response, 1999. WHO Recommended Surveillance Standards. Geneva: World Health Organization.

  • 6

    Oskam L, Nieuwenhuijs JL, Hailu A, 1999. Evaluation of the direct agglutination test (DAT) using freeze-dried antigen for the detection of anti-Leishmania antibodies in stored sera from various patient groups in Ethiopia. Trans R Soc Trop Med Hyg 93 :275–277.

    • Search Google Scholar
    • Export Citation
  • 7

    de Onis M, Garza C, Victora CG, Onyango AW, Frongillo EA, Martines J, 2004. The WHO Multicentre Growth Reference Study: planning, study design, and methodology. Food Nutr Bull 25 :S15–S26.

    • Search Google Scholar
    • Export Citation
  • 8

    de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J, 2007. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ 85 :660–667.

    • Search Google Scholar
    • Export Citation
  • 9

    Garza C, de Onis M, 2004. Rationale for developing a new international growth reference. Food Nutr Bull 25 :S5–S14.

  • 10

    Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C, 2004. Conflict and kala-azar: determinants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis 38 :612–619.

    • Search Google Scholar
    • Export Citation
  • 11

    Lyons S, Veeken H, Long J, 2003. Visceral leishmaniasis and HIV in Tigray, Ethiopia. Trop Med Int Health 8 :733–739.

  • 12

    Werneck GL, Batista MS, Gomes JR, Costa DL, Costa CH, 2003. Prognostic factors for death from visceral leishmaniasis in Teresina, Brazil. Infection 31 :174–177.

    • Search Google Scholar
    • Export Citation
  • 13

    Ritmeijer K, Dejenie A, Assefa Y, Hundie TB, Mesure J, Boots G, den Boer M, Davidson RN, 2006. A comparison of miltefosine and sodium stibogluconate for treatment of visceral leishmaniasis in an Ethiopian population with high prevalence of HIV infection. Clin Infect Dis 43 :357–364.

    • Search Google Scholar
    • Export Citation
  • 14

    Gebre-Michael T, Balkew M, Alamirew T, Gudeta N, Reta M, 2007. Preliminary entomological observations in a highland area of Amhara region, northern Ethiopia, with epidemic visceral leishmaniasis. Ann Trop Med Parasitol 101 :367–370.

    • Search Google Scholar
    • Export Citation
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Natural History of a Visceral Leishmaniasis Outbreak in Highland Ethiopia

Mercè HerreroDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Giannos OrfanosDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Daniel ArgawDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Abate MulugetaDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Pilar AparicioDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Fernando ParreñoDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Oscar BernalDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Daniel RubensDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Jaime PedrazaDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Maria Angeles LimaDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Laurence FlevaudDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Pedro Pablo PalmaDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Seife BashayeDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Jorge AlvarDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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Caryn BernDisease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia; Médecins Sans Frontières-Ethiopia, Operational Centre Barcelona-Athens, Addis Zemen, Ethiopia; Department for the Control of Neglected Tropical Diseases, Leishmaniasis Control Program, World Health Organization, Geneva, Switzerland; National Centre of Tropical Medicine, Instituto de Salud Carlos III, Madrid, Spain; Médecins Sans Frontières, Medical Department, Operational Centre Barcelona-Athens (OCBA), Barcelona, Spain; Malaria and Other Vector Borne Diseases, Prevention and Control Program, Ministry of Health, Addis Ababa, Ethiopia; Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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In May 2005, visceral leishmaniasis (VL) was recognized for the first time in Libo Kemken, Ethiopia, a highland region where only few cases had been reported before. We analyzed records of VL patients treated from May 25, 2005 to December 13, 2007 by the only VL treatment center in the area, maintained by Médecins Sans Frontières-Ethiopia, Operational Center Barcelona-Athens. The median age was 18 years; 77.6% were male. The overall case fatality rate was 4%, but adults 45 years or older were five times as likely to die as 5–29 year olds. Other factors associated with increased mortality included HIV infection, edema, severe malnutrition, pneumonia, tuberculosis, and vomiting. The VL epidemic expanded rapidly over a several-year period, culminating in an epidemic peak in the last third of 2005, spread over two districts, and transformed into a sustained endemic situation by 2007.

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