Risk factors for anthroponotic cutaneous Leishmaniasis at the household level in Kabul, Afghanistan.
BACKGROUND
Kabul, Afghanistan, is the largest focus of anthroponotic cutaneous leishmaniasis (ACL) in the world. ACL is a protozoan disease transmitted to humans by the bite of phlebotomine sand flies. Although not fatal, ACL can lead to considerable stigmatization of affected populations.


METHODS
Using data from a standardized survey of 872 households in 4 wards of Kabul, Afghanistan, univariate and multivariate logistic regression analyses tested associations between presence of active ACL and ACL scars with 15 household-level variables.


RESULTS
Univariate analyses showed that active ACL was positively associated with household member's age, ACL prevalence, and brick wall type, but negatively associated with household number of rooms, bednet use, and proportion of windows with screens. Multivariate analysis showed a positive association between active ACL and household member's age, ACL prevalence, and brick wall type, and a negative association with household proportion of windows with screens.


CONCLUSIONS
Household-level characteristics were shown to be risk factors for ACL. Monitoring a selected number of household characteristics could assist in rapid assessments of household-level variation in risk of ACL. ACL prevention and control programs should consider improving house construction, including smoothing of walls and screening of windows.
Reithinger
Richard
R
HealthNet TPO, Kabul, Afghanistan. rreithinger@yahoo.co.uk
Mohsen
Mohammad
M
Leslie
Toby
T
D000293:Adolescent; D000328:Adult; D000346:Afghanistan / Q000453:epidemiology; D000367:Age Factors; D000818:Animals; D002648:Child; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007300:Insect Control; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology*; D008297:Male; D011576:Psychodidae; D012307:Risk Factors; D012867:Skin / Q000473:pathology; D055815:Young Adult