title: Risk factors of visceral leishmaniasis: a case control study in north-western Ethiopia.
abstract: BACKGROUND
  Visceral leishmaniasis (VL, also called ''kala-azar"), is a life threatening neglected tropical infectious disease which mainly affects the poorest of the poor. VL is prevalent in Ethiopia particularly in the northwest of the country. Understanding the risk factors of VL infection helps in its prevention and control. The aim of the present study was to identify the factors associated with VL.
  
  
  METHODS
  A case-control study was carried out during the period of January-July 2013 in northwest Ethiopia. Cases and controls were diagnosed using clinical presentation, the rk39 rapid diagnostic test and Direct Agglutination Test (DAT). A total of 283 (84.8% males versus 15.2% females) participants were interviewed. 90 cases and 193 controls were involved, matched by age, sex and geographical location with a ratio of 1:2 (case: controls). Univariate and backward multivariate conditional logistic regression were used to identify risk factors of VL.
  
  
  RESULTS
  Elevated odds of VL was associated with goat ownership (OR = 6.4; 95%: confidence interval [Cl]: 1.5-28.4), living in houses with cracked wall (OR = 6.4; 95% Cl: 1.6-25.6), increased family size (OR = 1.3; 95% Cl: 1.0-1.8) and the number of days spent in the farm field (OR = 1.1; 95% Cl: 1.0-1.2). However, daily individual activities around the home and farm fields, mainly sleeping on a bed (OR = 0.2; 95%: Cl 0.03-0.9), sleeping outside the house under a bed net (OR = 0.1; 95% Cl: 0.02-0.36)] and smoking plant parts in the house during the night time (OR = 0.1; 95% Cl: 0.01-0.6) were associated with decreased odds of being VL case.
  
  
  CONCLUSIONS
  Our findings showed that use of bed net and smoke could be helpful for the prevention of VL in the area particularly among individuals who spend most of their time in the farm. VL control effort could be focused on improving housing conditions, such as sealing cracks and crevices inside and outside houses. Further research is warranted to elucidate the role of goats in the transmission of L. donovani, assess the impact of bed nets and the role of the traditional practice of smoking plants.
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. solyar2005@yahoo.com.|Department of Biology, College of Natural Science, Jigjiga University, Jigjiga, Ethiopia. solyar2005@yahoo.com.
authors.forename: Solomon
authors.initials: S
authors.lastname: Yared
authors.affiliation: Brighton & Sussex Medical School, Falmer, Brighton, UK. kebededeka@yahoo.com.|School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia. kebededeka@yahoo.com.
authors.forename: Kebede
authors.initials: K
authors.lastname: Deribe
authors.affiliation: Department of Biology, College of Natural Science, Jigjiga University, Jigjiga, Ethiopia. shambe2006@yahoo.com.|School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia. shambe2006@yahoo.com.
authors.forename: Araya
authors.initials: A
authors.lastname: Gebreselassie
authors.affiliation: Department of Zoological Science, Addis Ababa University, Addis Ababa, Ethiopia. wssnlmm@yahoo.com.
authors.forename: Wessenseged
authors.initials: W
authors.lastname: Lemma
authors.affiliation: Department of Zoological Science, Addis Ababa University, Addis Ababa, Ethiopia. ak_esas@yahoo.com.
authors.forename: Essayas
authors.initials: E
authors.lastname: Akililu
authors.affiliation: Department of Microbiology and Molecular Genetics, The Institute of Medical Research Israel-Canada The Kuvin Center for the Study of Infectious and Tropical Diseases, Faculty of Medicine, The Hebrew University, Hadassah Medical School, Jerusalem, Israel. od.kirstein@mail.huji.ac.il.
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Kirstein
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. meshesha_b@yahoo.com.
authors.forename: Meshesha
authors.initials: M
authors.lastname: Balkew
authors.affiliation: Department of Microbiology and Molecular Genetics, The Institute of Medical Research Israel-Canada The Kuvin Center for the Study of Infectious and Tropical Diseases, Faculty of Medicine, The Hebrew University, Hadassah Medical School, Jerusalem, Israel. alonw@ekmd.huji.ac.il.
authors.forename: Alon
authors.initials: A
authors.lastname: Warburg
authors.affiliation: Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia. teshomegm@gmail.com.
authors.forename: Teshome
authors.initials: T
authors.lastname: Gebre-Michael
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia. hailu_a2004@yahoo.com.
authors.forename: Asrat
authors.initials: A
authors.lastname: Hailu
mesh_terms: D000293:Adolescent; D000328:Adult; D000822:Animal Husbandry; D000818:Animals; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005002:Ethiopia / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006041:Goats; D007722:Health Knowledge, Attitudes, Practice; D006798:Housing; D006801:Humans; D057148:Insecticide-Treated Bednets; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D008297:Male; D016273:Occupational Exposure; D012307:Risk Factors; D012906:Smoke; D013997:Time Factors; D055815:Young Adult
chemical_list: D012906:Smoke