scholarly journals Cases of Cutaneous Leishmaniasis in a peri-urban settlement in Kenya, 2016

2019 ◽  
Author(s):  
Isaac Ngere ◽  
Waqo Gofu ◽  
Abdikadir Isack ◽  
Joshua Muiruri ◽  
Mark Obonyo ◽  
...  

AbstractBackgroundCutaneous Leishmaniasis is a neglected tropical disease caused by a protozoan and transmitted by sand-fly bite. Following reports of a possible outbreak of cutaneous leishmaniasis in 2016, we conducted a review of hospital records and a follow up case control study to determine the magnitude of the disease, characterize the cases and identify factors associated with the disease in Gilgil, a peri-urban settlement in Central Kenya.MethodsWe reviewed hospital records, conducted active case search in the community and carried out a case-control study. Medical officers in the study team made clinical diagnosis of cutaneous leishmaniasis cases based on presence of a typical skin ulcer. We enrolled 58 cases matched by age and residence to 116 controls in a case control study. We administered structured questionnaires and recorded environmental observations around homes of cases and controls. Simple proportions, means and medians were calculated for categorical data and continuous data respectively. Logistic regression models were constructed for individual, indoor and outdoor factors associated with the outbreak.ResultsWe identified 255 suspected cases and one death; Females constituted 56% (142/255), median age of the cases was 7 years (IQR 14). Cases were clustered around Gitare (28.6%, 73/255) and Kambi-Turkana (14%, 36/255) with seasonal peaks between June-November. Among individual factors, staying outside the residence in the evening after sunset (OR 4.1, CI 1.2-16.2) and occupation involving visiting forests (OR 4.56, CI 2.04-10.22) had significant associations with disease. Sharing residence with a cutaneous leishmaniasis patient (OR 14.4, CI 3.8-79.3), a house with alternative roofing materials (OR 7.9, CI 1.9-45.7) and residing in a house with cracked walls (OR 2.3, CI 1.0-4.9) were significant among indoor factors while sighting rock hyraxes near residence (OR 5.3, CI 2.2-12.7), residing near a forest (OR 7.8, CI 2.8-26.4) and living close to a neighbour with cutaneous leishmaniasis (OR 6.8, CI 2.8-16.0) had increased likelihood of disease. Having a cultivated crop farm surrounding the residence (OR 0.1, CI 0.0-0.4) was protective.Conclusions/SignificanceThis study reveals the large burden of cutaneous leishmaniasis in Gilgil. There is strong evidence for both indoor and outdoor patterns of disease transmission. Occupations and activities that involve visiting forests or residing near forests and sharing a house or neighbourhood with a person with CL were identified as significant exposures of the disease. The role of environmental factors and wild mammals in disease transmission should be investigated furtherAuthor summaryLeishmaniasis is a group of diseases caused by a protozoa (Leishmania) and affects humans and other mammals following the bite of an infected sand-fly. Cutaneous form of the disease (cutaneous leishmaniasis) is considered a neglected tropical disease mainly affecting the poor destabilized or migrant populations in rural areas. Recently, the disease has expanded its geographical range and invaded previously non-endemic areas including areas surrounding large urban centres that are experiencing human population influx leading to multiple localised disease outbreaks. In this paper, we report findings of a study we conducted to determine the burden and factors promoting the spread of cutaneous leishmaniasis in a peri-urban settlement in Kenya. Our results indicate a high burden of cutaneous leishmaniasis in this area and an association of the disease with several groups of factors at individual, indoor and outdoor environments. Many cases of cutaneous leishmaniasis were linked to activities that involved visiting the forested areas around homes, underpinning the significance of human activity in forests in these areas in spread of the disease.

2003 ◽  
Vol 9 (4) ◽  
pp. 805-815
Author(s):  
A. Al Jawabreh ◽  
F. Barghuthy ◽  
L. F. Schnur ◽  
R. L. Jacobson ◽  
G. Schonian ◽  
...  

Thistudy of cutaneous leishmaniasis in Jericho city and the adjacent Aqbat-Jaber refugee camp investigated the seroprevalance of Leishmania major and the risk factors associated with acquiring the disease. Clinical and parasitology identification of cases showed children and young men were more affected, with the head most affected in children. Enzyme-linked immunosorbent assay [ELISA] was used to test sera from 190 individuals. The overall seroprevalence of cutaneous leishmaniasis was 26.3%. A case-control study of 247 individual in 37 households showed that a higher level of education of the head of the household and having children sleep under bed nets were significantly related to a lower incidence of cutaneous leishmaniasis


Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 320
Author(s):  
Fayaz Khan ◽  
Mohamed Faisal Chevidikunnan

Stroke is a major cause of disability worldwide, and balance impairments are common disabling factors in patients with stroke, leading to falls. Thus, the study objectives were as follows: (i) To find the prevalence of balance impairment among patients with stroke. (ii) To find out the factors associated with balance impairment in patients with stroke. This cross-sectional retrospective case control study involved eighty-one post stroke patients with a mean age of 58.36 ± 14.06, recruited from six hospitals, who underwent an assessment of balance, walking speed, depression and isometric strength of the ankle and knee. These patients were later categorized into subjects with good balance (<45) in the Berg balance scale (BBS) and those with poor balance (≥45), as cases and controls, to assess the factors associated with balance impairment using binary logistic regression. The prevalence of balance impairment among patients with stroke was 48.1%. The reduction in power of knee flexors (OR = 0.858), knee extensors (OR = 0.880) and ankle dorsiflexors (OR = 0.820) was found to be significantly associated with balance impairment, along with speed (OR = 1.187 (95% CI = 1.100, 1.280)), depression (OR = 1.331 (95% CI = 1.055–1.679)) and activities of daily living (OR = 0.313 (95% CI = 0.150–0.650)). In summary, around half of the patients with stroke exhibited balance impairments, with females being more prone.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bülent Çomçalı ◽  
Servet Kocaoz ◽  
Buket Altun Özdemir ◽  
Ömer Parlak ◽  
Birol Korukluoğlu

AbstractThe aim of this study is to compare patients with and without mastalgia and to analyze the factors affecting mastalgia and its severity. The patient’s age, height, weight, educational status, marital status, and occupation were recorded in all subjects. In addition, the women were asked about the presence of any risk factors for mastalgia, such as tea and coffee consumption, smoking, alcohol consumption, and weight gain. The sternal notch to nipple distance (SNND) was measured to determine whether there was breast sagging. Mastalgia was significantly more common in women with BMIs of > 30 kg/m2 (OR: 2.94, CI 1.65–5.24), those who were primary school graduates or illiterate (OR: 2.96, CI 1.6–5.46), and those with SNND values of 22–25 cm (OR: 2.94, CI 1.79–4.82). In these women, drinking more than 6 cups of tea a day (OR: 2.15, CI 1.32–3.5), smoking at least 10 cigarettes a day (OR: 2.94, CI 1.78–4.83), and drinking alcohol at least once a week (OR: 2.1, CI 1.12–3.91) were found to be important factors that increased the risk of mastalgia. As a result, it has been found that severe mastalgia complaints cause by obesity, sagging breasts, never giving birth, unemployment anxiety, regular smoking, alcohol use, and excessive tea consumption.


PLoS ONE ◽  
2020 ◽  
Vol 15 (7) ◽  
pp. e0236250
Author(s):  
Chador Tenzin ◽  
Natkamol Chansatitporn ◽  
Tashi Dendup ◽  
Tandin Dorji ◽  
Karma Lhazeen ◽  
...  

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Ravi Kumar Bhaskar ◽  
Krishna Kumar Deo ◽  
Uttam Neupane ◽  
Subhadra Chaudhary Bhaskar ◽  
Birendra Kumar Yadav ◽  
...  

Background. This study was done to assess the maternal and sociodemographic factors associated with low birth weight (LBW) babies.Methods. An unmatched case control study was done involving 159 cases (mothers having LBW singleton babies) and 159 controls (mothers having normal birth weight singleton babies).Results. More than 50% of LBW babies were from the mothers with height ≤145 cm while only 9.43% of NBW babies were from the mothers with that height. Finally, after multivariate logistic regression analysis, maternal height, time of first antenatal care (ANC) visit, number of ANC visits, iron supplementation, calcium supplementation, maternal education, any illness during pregnancy, and hypertension were found as the significant predictors of LBW. However, maternal blood group AB, normal maternal Body Mass Index (BMI), mother’s age of 30 or more years, and starting ANC visit earlier were found to be protective for LBW.Conclusion. Study findings suggest that selectively targeted interventions such as delay age at first pregnancy, improving maternal education and nutrition, and iron and calcium supplementation can prevent LBW in Nepal.


2021 ◽  
Author(s):  
FASSIATOU OLUWATOSIN TAIROU ◽  
Abdoulaye Diallo ◽  
Ousmane Sy ◽  
Aminatou Kone ◽  
Isaac Akhenaton Manga ◽  
...  

Abstract Background: In Senegal, malaria morbidity has shapely felt down over these past years. However, malaria epidemiology remains heterogeneous with persisting transmission in the southeastern part of the country and more important number of cases arising among older children and adolescents. Little is known about factors associated with clinical malaria among this group. A better understanding of malaria transmission among this new vulnerable group will guide future interventions targeting these key populations. This study aimed to identify factors associated with clinical malaria among adolescents in Senegal. Methods: A case control study was conducted from November to December 2020 in four health posts located in Saraya district. Cases were defined as adolescents (10-19 years) with uncomplicated malaria episode with fever (Temperature>37.5°) or history of fever and a positive malaria RDT. Controls were from the same age group, living in the neighborhood of the case, presenting a negative RDT. A standardized, pre-tested questionnaire was administered to each participant followed by home visit to assess participant’s living conditions. Factors associated with clinical malaria was assessed using a Stepwise Logistic regression analysis.Results: In total, 492 individuals were recruited (246 cases and 246 controls). In a multivariate analysis, factors associated with clinical malaria included non-use of bed net (aOR=2.65; 95% CI =1.58 - 4.45), non-use of other preventive measures (aOR=2.51; 95% CI=1.53 - 4.11) and indoor sleeping (aOR=3.22; 95%CI =1.66- 6.23). Protective factors included age of 15-19 years (aOR=0.38; 95% CI 0.23 - 0.62), absence of stagnant water around the house (aOR=0.27; 95% CI=0.16 - 0.44), having a female as head of household (aOR=0.47; 95% CI=0.25 - 0.90), occupation such as apprentice (OR=0.24; 95%CI=0.11 - 0.52).Conclusions: The study revealed that environmental factors and non-use of malaria preventive measures are the main determinant of malaria transmission among adolescents living in areas with persisting malaria transmission in Senegal. Strategies aiming at improving disease awareness and access to health care interventions such as LLIN are thus needed to improve malaria control and prevention among these vulnerable groups.


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