Risk factors, representations and practices associated with emerging urban human visceral leishmaniasis in Posadas, Argentina.
BACKGROUND
Visceral leishmaniasis is an often overlooked disease with high lethality rates about which there is need of additional local studies to inform the design of effective control strategies. The urbanization of its transmission has already been verified in America, with domestic dogs being the primary reservoirs and vectors of the disease. Socio-economic conditions, demographics and practices of domestic groups typically present in urban settings may play a specific role in the transmission of the infection, which is still poorly understood.


OBJECTIVE
To analyze the sociodemographic characteristics, risk factors and overall practices concerning prevention and coping strategies of visceral leishmaniasis, in both human beings and canines.


METHODS
This study utilized a cross-sectional case-control design. Cases were defined as a domestic group where the Public Health Ministry had at least one record of a member with human visceral leishmaniasis. Control cases were defined as a domestic group without a clinical record of the disease. The populations were characterized demographically and socially using primary information sources. Measures of household quality and a ranking of knowledge and attitudes towards visceral leishmaniasis were constructed, and practices associated with the presence, and the risk for canine visceral leishmaniasis were described.


RESULTS
Low household quality (p≤0.001), a member of the domestic group out of the household after 6:00 pm (OR=4.4; 95% CI: 1.69-12.18), the uncontrolled racial breeding of dogs (OR=15.7; 95% CI: 3.91-63.2), and the presence of infected dogs infected in the household (OR=120.3; 95% CI: 18.51-728.3) were variables positively associated with the risk of infection.


CONCLUSIONS
We observed certain social risk factors, primarily low household quality and overcrowding, associated with structural poverty that could increase human-vector contact probability. The most important risk factor for human visceral leishmaniasis was the possession of infected dogs in the household.
Secretaría de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina Universidad Nacional de Misiones, Misiones, Argentina. karenlopez34@yahoo.com.ar.
Karen
K
López
Lilian Catalina
LC
Tartaglino
Ingrid Iris
II
Steinhorst
María Soledad
MS
Santini
Oscar Daniel
OD
Salomon
D000818:Animals; D001118:Argentina; D003430:Cross-Sectional Studies; D004283:Dog Diseases / Q000453:epidemiology / Q000469:parasitology*; D004285:Dogs; D006801:Humans; D007303:Insect Vectors; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D012307:Risk Factors
Argentina.; Leishmaniasis; attitudes; health knowledge; neglected diseases; practice; risk factors; visceral