The Emerging Questions from the Current Epidemiology of Visceral Leishmaniasis in South Sudan: A Cross-sectional Study DesignKofi Boateng1, Abdulmunini Usman1*, Jane Pita1, Ajak CD Akik2, Allan Mpairwe1, Dieu-Donne Bimpa1, Evans Lyosi1, Sylvester Maleghemi1, Mabourok M Leron2, Rumunu John2, and Richard LL Loro2
- *Corresponding Author:
- Abdulmunini Usman
World Health Organization Country Office
Juba, South Sudan
Tel: +211 953 333 842
E-mail: [email protected]
Received date: November 23, 2016; Accepted date: January 03, 2017; Published date: January 14, 2017
Citation: Boateng K, Usman A, Pita J, Akik ACD, Mpairwe A, et al. (2017) The Emerging Questions from the Current Epidemiology of Visceral Leishmaniasis in South Sudan: A Cross-sectional Study Design. J Emerg Infect Dis 2:121. doi:10.4172/2472-4998.1000121
Copyright: © 2017 Boateng K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Leishmaniasis is endemic in South Sudan with at least two outbreaks reported since 1984. A major impediment to effective control is the paucity of epidemiological data to inform prevention and control efforts. The intent of this study is to describe the epidemiology of the disease to inform prevention and control interventions.
An analytical cross-sectional design was applied to the National Leishmaniasis Surveillance database from 2009 to 2013 to determine trends and influences on risk of death. Leishmaniasis cases were defined according to national disease surveillance protocols. Point estimates at 95% C.I. and regression estimates of odds and R2 of risks outcomes were determined.
The prevalence (cases per 10,000) of visceral leishmaniasis (VL) in the endemic areas varied from 0.14 in 2009 to 5.13 in 2011 and 0.2 in 2013. During this period, 2,466 cases were reported of which 89.5% (95% C.I. 88.2-90.6) had primary visceral leishmaniasis while 7.1% (95% C.I 6.2-8.2) were relapse cases. Following treatment, 90.7% (95% C.I. 89.4-91.8) of cases were cured, with a case fatality of 3.7% (95% C.I. 3.0-4.5). Age (R2=0.02, p <0.001), duration of illness (R2=0.01, p<0.001), and treatment regimen (R2=0.039, p<0.001) significantly explained the risk of death even though marginal. Primary Visceral leishmaniasis were 2.5 times (OR=2.5 [95% C.I. 1.4, 4.6]; p<0.002) more likely to die as compared to other categories. There are epidemic foci in North Eastern counties of Ayod, Fangak, Baliet and Canal Khorfulus. Further studies, both ecological and behavioral are required to understand the risk of exposure to VL.