Haftom Mekonnen, Petrucka Pammla, Gemechu Kbrom, Nesro Jemila, Amare Embay, Hailu Tsegu, Ashebir Yohannes, Gebreheat Gdiom, Hagos Haftea, Gebremedhin Destaalem, Gebremariam Alem
Department of Nursing, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia.
College of Nursing, University of Saskatchewan, Saskatchewan, Canada.
Infect Dis Ther. 2021 Mar;10(1):47-60. doi: 10.1007/s40121-020-00361-y. Epub 2020 Nov 10.
INTRODUCTION: Tropical diseases are public health problems affecting hundreds of millions of people globally. However, the development of adequate, affordable, and accessible treatments is mostly neglected, resulting in significant morbidity and mortality that could otherwise be averted. Leishmaniasis is one of the neglected tropical diseases caused by the obligate intracellular protozoan Leishmania parasite and transmitted by the bite of infected phlebotomine sandflies. No systematic review and meta-analysis has been done to identify the prevalence and risk factors of leishmaniasis to the authors' knowledge. Therefore, the objective was to determine the prevalence and risk factors of human leishmaniasis in Ethiopia. METHODS: Eleven studies conducted in all regions of Ethiopia, which were fully accessible, written in any language, and original articles done on prevalence and risk factors of leishmaniasis, were included. STATA™ version 11.1 was used for statistical analysis. Chi-square, I, and p values were assessed to check heterogeneity. A random effects model with heterogeneity taken from an inverse-variance model was employed to estimate the pooled effect. Subgroup meta-analysis was computed to reduce random variations among each article's point prevalence, and Egger and funnel plots were used to check for publication bias. RESULTS: The highest proportion of human leishmaniasis was reported from a study done in Amhara region (39.1%), and the lowest was reported from a survey done in Tigray (2.3%). The overall pooled prevalence of leishmaniasis was 9.13% (95% CI 5-13.27). Subgroup analysis by region revealed moderate heterogeneity (I = 51.8%) in studies conducted in the Southern Nations Nationalities and Peoples Region (SNNPR). The presence of hyraxes and being male were associated with an increased risk of human leishmaniasis. CONCLUSION: The prevalence of leishmaniasis in Ethiopia remains high (9.13%), with significant risk factors being male and the presence of hyraxes within a 300-m radius of the sleeping area.
引言：热带疾病是影响全球数亿人的公共卫生问题。然而，开发充足、可负担且可及的治疗方法大多被忽视，导致了原本可以避免的显著发病率和死亡率。利什曼病是由专性细胞内原生动物利什曼原虫寄生虫引起、通过受感染的白蛉叮咬传播的被忽视热带疾病之一。据作者所知，尚未进行系统评价和荟萃分析来确定利什曼病的患病率和危险因素。因此，目的是确定埃塞俄比亚人类利什曼病的患病率和危险因素。 方法：纳入了在埃塞俄比亚所有地区进行的11项研究，这些研究完全可获取、用任何语言撰写且是关于利什曼病患病率和危险因素的原创文章。使用STATA™ 11.1版进行统计分析。评估卡方、I²和p值以检查异质性。采用从逆方差模型获取异质性的随机效应模型来估计合并效应。计算亚组荟萃分析以减少各文章点患病率之间的随机变异，并使用Egger图和漏斗图检查发表偏倚。 结果：人类利什曼病比例最高的报告来自阿姆哈拉地区的一项研究（39.1%），最低的报告来自提格雷的一项调查（2.3%）。利什曼病的总体合并患病率为9.13%（95%置信区间5 - 13.27）。按地区进行的亚组分析显示，在南方各族州（SNNPR）进行的研究存在中度异质性（I² = 51.8%）。有蹄兔和男性与人类利什曼病风险增加相关。 结论：埃塞俄比亚利什曼病的患病率仍然很高（9.13%），重要的危险因素是男性以及睡眠区域半径300米内有蹄兔的存在。
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