title: Risk factors for visceral leishmaniasis in India: further evidence on the role of domestic animals.
abstract: OBJECTIVE
  Studies investigating risk factors for visceral leishmaniasis (VL) on the Indian Subcontinent have shown contradictory results related to the role of domestic animals. In some studies having animals in or around the house was a risk factor, in others it was protective. We investigated the specific hypothesis that keeping domestic animals inside the house at night is a risk factor for VL.
  
  
  METHODS
  Individually matched case-control study. All patients with VL diagnosed in the study area in Bihar, India between March 1st, 2007 and December 1st, 2008 were eligible. For each case, we selected two random controls, with no history of previous VL; matched on sex, age group and neighbourhood. Patients and controls were subjected to a structured interview on the main exposure of interest and potential confounders; a conditional logistic regression model was used to analyse the data.
  
  
  RESULTS
  We enrolled 141 patients and 282 controls. We found no significant associations between VL and keeping domestic animals inside the house (OR of 0.88 for bovines and 1.00 for 'any animal') or ownership of domestic animals (OR of 0.97 for bovines and 1.02 for 'any animal'). VL was associated with housing conditions. Living in a thatched house (OR 2.60, 95% CI 1.50-4.48) or in a house with damp floors (OR 2.60, 95% CI 1.25-5.41) were risk factors, independently from socio economic status.
  
  
  CONCLUSIONS
  Keeping animals inside the house is not a risk factor for VL in Bihar, India. Improving housing conditions for the poor has the potential to reduce VL incidence.
authors.affiliation: Institute of Medical Sciences Banaras Hindu University, Varanasi, India.
authors.forename: S P
authors.initials: SP
authors.lastname: Singh
authors.forename: E
authors.initials: E
authors.lastname: Hasker
authors.forename: A
authors.initials: A
authors.lastname: Picado
authors.forename: K
authors.initials: K
authors.lastname: Gidwani
authors.forename: P
authors.initials: P
authors.lastname: Malaviya
authors.forename: R P
authors.initials: RP
authors.lastname: Singh
authors.forename: M
authors.initials: M
authors.lastname: Boelaert
authors.forename: S
authors.initials: S
authors.lastname: Sundar
mesh_terms: D000293:Adolescent; D000328:Adult; D000822:Animal Husbandry / Q000379:methods*; D000818:Animals; D000829:Animals, Domestic; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006798:Housing / Q000592:standards; D006801:Humans; D007194:India / Q000453:epidemiology; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000209:etiology / Q000635:transmission*; D008297:Male; D008875:Middle Aged; D012923:Social Class; D055815:Young Adult