title: Kala-azar outbreak in Libo Kemkem, Ethiopia: epidemiologic and parasitologic assessment.
abstract: In May 2005, visceral leishmaniasis (VL) was recognized for the first time in Libo Kemkem, Ethiopia. In October 2005, a rapid assessment was conducted using data from 492 patients with VL treated in the district health center and a household survey of 584 residents of four villages. One subdistrict accounted for 71% of early cases, but the incidence and number of affected subdistricts increased progressively throughout 2004-2005. In household-based data, we identified 9 treated VL cases, 12 current untreated cases, and 19 deaths attributable to VL (cumulative incidence, 7%). Thirty percent of participants were leishmanin skin test positive (men, 34%; women, 26%; P = 0.06). VL was more common in men than women (9.7% versus 4.5%, P < 0.05), possibly reflecting male outdoor sleeping habits. Molecular typing in splenic aspirates showed L. infantum (six) and L. donovani (one). Local transmission resulted from multiple introductions, is now well established, and will be difficult to eradicate.
authors: Department for the Control of Neglected Tropical Diseases (CDS/NTD/IDM), Leishmaniasis Control Program, World Health Organization, 20 Avenue Appia, CH-1211 Geneva, Switzerland. alvarj@who.int
authors: Jorge
authors: J
authors: Alvar
authors: Seife
authors: S
authors: Bashaye
authors: Daniel
authors: D
authors: Argaw
authors: Israel
authors: I
authors: Cruz
authors: Pilar
authors: P
authors: Aparicio
authors: Askal
authors: A
authors: Kassa
authors: Giannos
authors: G
authors: Orfanos
authors: Fernando
authors: F
authors: Parreño
authors: Olusegan
authors: O
authors: Babaniyi
authors: Nigussu
authors: N
authors: Gudeta
authors: Carmen
authors: C
authors: Cañavate
authors: Caryn
authors: C
authors: Bern
mesh_terms: D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000818:Animals; D002648:Child; D002675:Child, Preschool; D021901:DNA, Intergenic / Q000737:chemistry / Q000235:genetics; D016054:DNA, Protozoan / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007891:Leishmania / Q000235:genetics / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012424:Rural Population; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D021901:DNA, Intergenic; D016054:DNA, Protozoan