Prevalence of human visceral leishmaniasis and its risk factors in Eastern Africa: a systematic review and meta-analysis.

INTRODUCTION

Visceral Leishmaniasis, also known as kala-azar, is a potentially fatal, neglected tropical disease caused by the protozoan parasite and transmitted through infected sandflies. It is one of the major global public health problems and contributors to economic crisis among people. Though different studies investigated human visceral leishmaniasis in Eastern Africa, the findings were inconsistent and inconclusive enough, and there is no representative data on this devastating public health concern. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence and risk factors associated with human visceral leishmaniasis in Eastern Africa.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA 2020) guidelines were followed for this study. Databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Web of Science, Cochrane Library, Google Scholar, Semantic Scholar, and Google were used to retrieve all the relevant articles. The search was carried out from 23 May 2024 to 17 July 2024. Data were analyzed using STATA 17 software to determine the pooled prevalence of human visceral leishmaniasis with a 95% confidence interval using a random-effects model.

RESULT

In this meta-analysis, thirty-nine articles with 40,367 study participants were included. The overall pooled prevalence of human visceral leishmaniasis in Eastern Africa was 26.16% [95%; CI: 19.96, 32.36%; I = 99.67%;  = 0.00]. Gender, age, family size, presence of termite hill/mound, presence of cattle/domestic animals, outdoor sleeping, presence of VL infected family member/s, and presence of water source/pathway near home were the risk factors significantly associated with human visceral leishmaniasis.

CONCLUSION

The recorded pooled prevalence of human visceral leishmaniasis in Eastern Africa underscores the urgent need for comprehensive intervention strategies. This includes rigorous health education for residents, covering the disease's cause, transmission, vector breeding sites, and prevention mechanisms.