title: Natural history of a visceral leishmaniasis outbreak in highland Ethiopia.
abstract: 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.
authors.affiliation: Disease Prevention and Control Programmes, World Health Organization, Addis Ababa, Ethiopia.
authors.forename: Mercè
authors.initials: M
authors.lastname: Herrero
authors.forename: Giannos
authors.initials: G
authors.lastname: Orfanos
authors.forename: Daniel
authors.initials: D
authors.lastname: Argaw
authors.forename: Abate
authors.initials: A
authors.lastname: Mulugeta
authors.forename: Pilar
authors.initials: P
authors.lastname: Aparicio
authors.forename: Fernando
authors.initials: F
authors.lastname: Parreño
authors.forename: Oscar
authors.initials: O
authors.lastname: Bernal
authors.forename: Daniel
authors.initials: D
authors.lastname: Rubens
authors.forename: Jaime
authors.initials: J
authors.lastname: Pedraza
authors.forename: Maria Angeles
authors.initials: MA
authors.lastname: Lima
authors.forename: Laurence
authors.initials: L
authors.lastname: Flevaud
authors.forename: Pedro Pablo
authors.initials: PP
authors.lastname: Palma
authors.forename: Seife
authors.initials: S
authors.lastname: Bashaye
authors.forename: Jorge
authors.initials: J
authors.lastname: Alvar
authors.forename: Caryn
authors.initials: C
authors.lastname: Bern
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult