Outbreak investigation of Visceral Leishmaniasis in Borena Zone, Oromia Region, Ethiopia, November 2019: Case Control study

Background Visceral Leishmaniasis (VL) caused by Leishmania parasites, infects mammals transmitted by Phlebotomine sand-flies and mostly affects the poorest. VL distributed worldwide and prevalent in Ethiopia. Knowing occurrence of disease and risk factor is a remedy for controlling. The aim of study was to identify factors associated with VL. Methods Case control study was carried out during October-November 2019 in Borena. A 1:2 Cases and controls were identified by case definition and 33 cases were included in the study. Participants >18years interviewed and caregivers of <18 were questioned for legal issue. Epi-info and SPSS were used for data entry and analysis. Primarily predictors were identified using chi-square at significant level P<0.05 with 95%CI, then candidate predictors were analysed using bivariate and multivariate analysis to identify associated factors. Result Among 153 suspected cases, 9 suspected deaths reported; 33 (22%) cases and 3 deaths were verified for VL. Among 33 verified cases 15(45.5%) were in July 2019, in comparison of 4years data, there is surge cases in July-August 2019, 26(79%) of cases were from Dire, Attack Rate (AR) = 15/100,000, CFR=9.1%. Among all, 15-64year were highly affected with AR=19.3. A case control engaged 99(100%) respondents and among all 93(93.9%) were male, 68(68.8%) were 15-64years. Adult education Adjusted Odds Ratio (AOR) = 30.438(2.378, 389.602), bed-net AOR=9.024 (1.763, 46.205) and walling AOR=0.052(0.004, 0.739) were associated factors with VL at 95%CI with p-value<0.05. Conclusion Male 15-64years were highly susceptible. Level of education, ITNs and walling were associated factors with VL. Formulating policies and guidelines for male 15-64 years related vector control and awareness creation regarding feeding habit of sand fly, prevention and control were recommended. Awareness of community on prevention method; using repellents, ITNs utilization, and safe sleeping mechanisms are mandatory. Further investigation on the issue is best remedy to overcome future VL outbreak occurrence.