Merdekios Behailu, Kote Mesfin, Pareyn Myrthe, Van Geertruyden Jean-Pierre, van Griensven Johan
Arba Minch University, Arba Minch, Ethiopia.
Institute of Tropical Medicine, Antwerp, Belgium.
PLoS One. 2024 Dec 30;19(12):e0311917. doi: 10.1371/journal.pone.0311917. eCollection 2024.
Although there are several areas in southern Ethiopia environmentally favourable for cutaneous leishmaniasis (CL), studies on the existence and risk factors of CL are lacking beyond a few well-known hotspots. This study aimed to assess the prevalence and risk factors of CL in Bilala Shaye, a village in the southern Ethiopian highlands at an altitude of 2,250 meters.
A cross-sectional house-to-house survey was done between July-August 2021. Those with skin lesions were clinically assessed and data on individual risk behaviour and environmental and household features were collected using questionnaires. Univariate and multivariable logistic regression models were used to identify independent risk factors of CL at a 5% significance level with two-sided P-values <0.05 considered statistically significant.
A total of 1012 individuals were interviewed; the median age was 23 years (interquartile range 12-50), with 7% below the age of five; 51% were female. All households had domestic animals, and for 143 (57%) households goats/sheep lived inside or around the house. Animal dung was found in the compounds of 194 (77%) households. The overall prevalence of active CL was 2.5% (95% confidence interval (CI) 1.6-3.6), reaching 6.7% (95% CI 3.6-11.2) in children between 5-12 years old. The prevalence of CL scars was 38.5% (95% CI 35.5-41.6). In multivariate analysis, the presence of animal dung in the compound (adjusted odds ratio (OR) 2.1; 95% CI: 1.3-3.5, P = 0.003) and time spent outside in the late evening in areas where hyraxes live (adjusted OR 2.4; 95% CI: 1.7-3.3, P <0.001) were identified as independent risk factors.
This is the first report on the existence of CL in this village, with the high prevalence of CL scars indicating long-term endemicity. Further studies are needed to understand the role of animals and their dung in (peri)-domestic CL transmission.
尽管埃塞俄比亚南部有几个地区在环境上有利于皮肤利什曼病（CL）的发生，但除了少数几个知名的热点地区外，关于CL的存在情况和危险因素的研究尚属缺乏。本研究旨在评估埃塞俄比亚南部高地海拔2250米的比拉拉·沙耶村CL的患病率及危险因素。
于2021年7月至8月期间开展了一项逐户横断面调查。对有皮肤病变的患者进行临床评估，并通过问卷收集个体风险行为以及环境和家庭特征方面的数据。采用单变量和多变量逻辑回归模型，在5%的显著性水平下确定CL的独立危险因素，双侧P值<0.05被认为具有统计学意义。
共访谈了1012人；年龄中位数为23岁（四分位间距12 - 50岁），5岁以下儿童占7%；女性占51%。所有家庭均饲养家畜，143户（57%）家庭的山羊/绵羊生活在房屋内或房屋周围。194户（77%）家庭的院子里发现有动物粪便。活动性CL的总体患病率为2.5%（95%置信区间（CI）1.6 - 3.6），5 - 12岁儿童中患病率达6.7%（95% CI 3.6 - 11.2）。CL疤痕的患病率为38.5%（95% CI 35.5 - 41.6）。在多变量分析中，院子里存在动物粪便（调整比值比（OR）2.1；95% CI：1.3 - 3.5，P = 0.003）以及在蹄兔生活区域傍晚在户外停留的时间（调整OR 2.4；95% CI：1.7 - 3.3，P <0.001）被确定为独立危险因素。
这是关于该村庄存在CL的首份报告，CL疤痕的高患病率表明该病长期流行。需要进一步开展研究以了解动物及其粪便在（周边）家庭CL传播中的作用。
