Visceral Leishmaniasis in Benishangul-Gumuz Regional State, Western Ethiopia: Reemerging or Emerging?

Adugna Abera Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

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Geremew Tasew Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Ethiopian Public Health Institute, Addis Ababa, Ethiopia.

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Teshome Tsegaw Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

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Asfaw Kejella Benishangul-Gumuz Regional Health Bureau, Assosa, Ethiopia.

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Abate Mulugeta Disease Prevention and Control Programs, World Health Organization, Ethiopia Country Office, Addis Ababa, Ethiopia.

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Dagimlidet Worku KalaCORE Consortium, Ethiopia Country Office, Addis Ababa, Ethiopia.

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Abraham Aseffa Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

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Endalamaw Gadisa Armauer Hansen Research Institute, Addis Ababa, Ethiopia.

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Kala-azar is a growing public health problem in Ethiopia. Benishangul-Gumuz regional state was previously not known to be endemic for the disease. In response to a case report from the region, we conducted a rapid assessment survey. A pretested questionnaire was used to capture sociodemographic and clinical histories pertinent to kala-azar. Study participants with complaints of fever and headache for 2 weeks or more were tested for kala-azar and malaria. All participants were screened with the leishmanin skin test and the direct agglutination test for exposure to Leishmania, defined as a positive result with either or both tests. Of 275 participants, 20 were exposed giving an overall leishmaniasis seroprevalence rate of 7.3%. Among the 20 positive individuals, 19 were farmers and nine of them reported no travel history outside their district. It appears that kala-azar is emerging in Dangur and Guba districts of Benishangul-Gumuz regional state, probably in connection with human encroachment into one or several previously out-of-reach zoonotic foci. We recommend integrated epidemiological surveys for confirmation and early containment of disease transmission in the area.

Author Notes

* Address correspondence to Endalamaw Gadisa, Armauer Hansen Research Institute, Jimma Road, P.O. Box 1005, Addis Ababa, Ethiopia 1005. E-mail: endalamawgadisa@yahoo.com

Financial support: This work was supported by WHO-Ethiopia and AHRI core budget (supported by Norad and SIDA).

Authors' addresses: Adugna Abera, Teshome Tsegaw, Abraham Aseffa, and Endalamaw Gadisa, Armauer Hansen Research Institute, Addis Ababa, Ethiopia, E-mails: adugnabe@yahoo.com, teshomegis@gmail.com, aseffaa@gmail.com, and endalamawgadisa@yahoo.com. Geremew Tasew, Ethiopian Public Health Institute, Addis Ababa, Ethiopia, E-mail: getas73@yahoo.com. Asfaw Kejella, Benishangul-Gumuz Regional Health Bureau, Assosa, Ethiopia, E-mail: kejellaasfaw@yahoo.com. Abate Mulugeta, World Health Organization, Ethiopia Country Office, Addis Ababa, Ethiopia, E-mail: abatem@who.int. Dagimlidet Worku, KalaCORE Consortium, Ethiopia Country Office, Addis Ababa, Ethiopia, E-mail: dagimlidet@gmail.com.

  • 1.

    Alvar J, Velez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M, WHO Leishmaniasis Control Team, 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.

    • Search Google Scholar
    • Export Citation
  • 2.

    Tsegaw T, Gadisa E, Seid A, Abera A, Teshome A, Mulugeta A, Herrero M, Argaw D, Jorge A, Aseffa A, 2013. Identification of environmental parameters and risk mapping of visceral leishmaniasis in Ethiopia by using geographical information systems and a statistical approach. Geospat Health 7: 299308.

    • Search Google Scholar
    • Export Citation
  • 3.

    Federal Ministry of Health, 2013. Guidelines for Diagnosis, Treatment and Prevention of Leishmaniasis in Ethiopia, 2nd edition. Addis Ababa, Ethiopia: Ethiopian Federal Ministry of Health.

    • Search Google Scholar
    • Export Citation
  • 4.

    Gadisa E, Tsegaw T, Abera A, Elnaiem DE, den Boer M, Aseffa A, Jorge A, 2015. Eco-epidemiology of visceral leishmaniasis in Ethiopia. Parasit Vectors 8: 381.

    • Search Google Scholar
    • Export Citation
  • 5.

    Boussery G, Boelaert M, van Peteghem J, Ejikon P, Henckaerts K, 2001. Visceral leishmaniasis (kala-azar) outbreak in Somali refugees and Kenyan shepherds, Kenya. Emerg Infect Dis 7: 603604.

    • Search Google Scholar
    • Export Citation
  • 6.

    Abubakar A, Ruiz-Postigo JA, Pita J, Lado M, Ben-Ismail R, Argaw D, Alvar J, 2014. Visceral leishmaniasis outbreak in South Sudan 2009–2012: epidemiological assessment and impact of a multisectoral response. PLoS Negl Trop Dis 8: e2720.

    • Search Google Scholar
    • Export Citation
  • 7.

    Raguenaud ME, Jansson A, Vanlerberghe V, Deborggraeve S, Dujardin JC, Orfanos G, Reid T, Boelaert M, 2007. Epidemiology and clinical features of patients with visceral leishmaniasis treated by an MSF clinic in Bakool region, Somalia, 2004–2006. PLoS Negl Trop Dis 1: e85.

    • Search Google Scholar
    • Export Citation
  • 8.

    Kirstein OD, Faiman R, Gebreselassie A, Hailu A, Gebre-Michael T, Warburg A, 2013. Attraction of Ethiopian phlebotomine sand flies (Diptera: Psychodidae) to light and sugar-yeast mixtures (CO2). Parasit Vectors 6: 341.

    • Search Google Scholar
    • Export Citation
  • 9.

    Abbasi I, Aramin S, Hailu A, Shiferaw W, Kassahun A, Belay S, Jaffe C, Warburg A, 2013. Evaluation of PCR procedures for detecting and quantifying Leishmania donovani DNA in large numbers of dried human blood samples from a visceral leishmaniasis focus in northern Ethiopia. BMC Infect Dis 13: 153.

    • Search Google Scholar
    • Export Citation
  • 10.

    Gebresilassie A, Yared S, Aklilu E, Kirstein OD, Moncaz A, Tekie H, Balkew M, Warburg A, Hailu A, Gebre-Michael T, 2015. Host choice of Phlebotomus orientalis (Diptera: Psychodidae) in animal baited experiments: a field study in Tahtay Adiyabo district, northern Ethiopia. Parasit Vectors 8: 190.

    • Search Google Scholar
    • Export Citation
  • 11.

    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: 275282.

    • Search Google Scholar
    • Export Citation
  • 12.

    Herrero M, Orfanos G, Argaw D, Mulugeta A, Aparicio P, Parreno F, Bernal O, Rubens D, Pedraza J, Lima MA, Flevaud L, Palma PP, Bashaye S, Alvar J, Bern C, 2009. Natural history of a visceral leishmaniasis outbreak in highland Ethiopia. Am J Trop Med Hyg 81: 373377.

    • Search Google Scholar
    • Export Citation
  • 13.

    Lyons S, Veeken H, Long J, 2003. Visceral leishmaniasis and HIV in Tigray, Ethiopia. Trop Med Int Health 8: 733739.

  • 14.

    Shanks L, Ritmeijer K, Piriou E, Siddiqui MR, Kliescikova J, Pearce N, Ariti C, Muluneh L, Masiga J, Abebe A, 2015. Accounting for false positive HIV tests: is visceral leishmaniasis responsible? PLoS One 10: e0132422.

    • Search Google Scholar
    • Export Citation
  • 15.

    Ali A, Ashford RW, 1993. Visceral leishmaniasis in Ethiopia. I. Cross-sectional leishmanin skin test in an endemic locality. Ann Trop Med Parasitol 87: 157161.

    • Search Google Scholar
    • Export Citation
  • 16.

    Hailu A, Gramiccia M, Kager PA, 2009. Visceral leishmaniasis in Aba-Roba, south-western Ethiopia: prevalence and incidence of active and subclinical infections. Ann Trop Med Parasitol 103: 659670.

    • Search Google Scholar
    • Export Citation
  • 17.

    Fuller GK, Lemma A, Haile T, Atwood CL, 1976. Kala-azar in Ethiopia I: Leishmanin skin test in Setit Humera, a kala-azar endemic area in northwestern Ethiopia. Ann Trop Med Parasitol 70: 147163.

    • Search Google Scholar
    • Export Citation
  • 18.

    Gebre-Michael T, Balkew M, Berhe N, Hailu A, Mekonnen Y, 2010. Further studies on the phlebotomine sandflies of the kala-azar endemic lowlands of Humera-Metema (north-west Ethiopia) with observations on their natural blood meal sources. Parasit Vectors 3: 6.

    • Search Google Scholar
    • Export Citation
  • 19.

    Gebre-Michael T, Lane RP, 1996. The roles of Phlebotomus martini and P. celiae (Diptera: Phlebotominae) as vectors of visceral leishmaniasis in the Aba Roba focus, southern Ethiopia. Med Vet Entomol 10: 5362.

    • Search Google Scholar
    • Export Citation
  • 20.

    Elnaiem DA, Hassan HK, Ward RD, 1997. Phlebotomine sandflies in a focus of visceral leishmaniasis in a border area of eastern Sudan. Ann Trop Med Parasitol 91: 307318.

    • Search Google Scholar
    • Export Citation
  • 21.

    Elnaiem DA, Hassan MM, Maingon R, Nureldin GH, Mekawi AM, Miles M, Ward RD, 2001. The Egyptian mongoose, Herpestes ichneumon, is a possible reservoir host of visceral leishmaniasis in eastern Sudan. Parasitology 122: 531536.

    • Search Google Scholar
    • Export Citation
  • 22.

    Elnaiem DE, Hassan HK, Osman OF, Maingon RD, Killick-Kendrick R, Ward RD, 2011. A possible role for Phlebotomus (Anaphlebotomus) rodhaini (Parrot, 1930) in transmission of Leishmania donovani. Parasit Vectors 4: 238.

    • Search Google Scholar
    • Export Citation
  • 23.

    Marlet MV, Sang DK, Ritmeijer K, Muga RO, Onsongo J, Davidson RN, 2003. Emergence or re-emergence of visceral leishmaniasis in areas of Somalia, north-eastern Kenya, and south-eastern Ethiopia in 2000–01. Trans R Soc Trop Med Hyg 97: 515518.

    • Search Google Scholar
    • Export Citation
  • 24.

    Anema A, Ritmeijer K, 2005. Treating HIV/AIDS and leishmaniasis coinfection in Ethiopia. CMAJ 172: 14341435.

  • 25.

    Hailu A, Gebre-Michael T, Berhe N, Balkew M, 2006. Leishmaniasis. Berhane Y, Mariam DH, Kloos H, eds. Epidemiology and Ecology of Health and Disease in Ethiopia. Addis Ababa, Ethiopia: Shama Books.

    • Search Google Scholar
    • Export Citation
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