title: Risk factors for kala-azar in Bangladesh.
abstract: Since 1990, South Asia has experienced a resurgence of kala-azar (visceral leishmaniasis). To determine risk factors for kala-azar, we performed cross-sectional surveys over a 3-year period in a Bangladeshi community. By history, active case detection, and serologic screening, 155 of 2,356 residents had kala-azar with onset from 2000 to 2003. Risk was highest for persons 3-45 years of age, and no significant difference by sex was seen. In age-adjusted multivariable models, 3 factors were identified: proximity to a previous kala-azar patient (odds ratio [OR] 25.4, 95% confidence interval [CI] 15-44 within household; OR 3.2 95% CI 1.7-6.1 within 50 m), bed net use in summer (OR 0.7, 95% CI 0.53-0.93), and cattle per 1,000 m2 (OR 0.8, 95% CI 0.70-0.94]). No difference was seen by income, education, or occupation; land ownership or other assets; housing materials and condition; or keeping goats or chickens inside bedrooms. Our data confirm strong clustering and suggest that insecticide-treated nets could be effective in preventing kala-azar.
authors.affiliation: Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. Cbern@cdc.gov
authors.forename: Caryn
authors.initials: C
authors.lastname: Bern
authors.forename: Allen W
authors.initials: AW
authors.lastname: Hightower
authors.forename: Rajib
authors.initials: R
authors.lastname: Chowdhury
authors.forename: Mustakim
authors.initials: M
authors.lastname: Ali
authors.forename: Josef
authors.initials: J
authors.lastname: Amann
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Wagatsuma
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.forename: Katie
authors.initials: K
authors.lastname: Kurkjian
authors.forename: Louise E
authors.initials: LE
authors.lastname: Vaz
authors.forename: Moarrita
authors.initials: M
authors.lastname: Begum
authors.forename: Tangin
authors.initials: T
authors.lastname: Akter
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Cetre-Sossah
authors.forename: Indu B
authors.initials: IB
authors.lastname: Ahluwalia
authors.forename: Ellen
authors.initials: E
authors.lastname: Dotson
authors.forename: W Evan
authors.initials: WE
authors.lastname: Secor
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: James H
authors.initials: JH
authors.lastname: Maguire
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012621:Seasons; D012959:Socioeconomic Factors