Trend of visceral leishmaniasis at Medicine Sans Frontier´s Abdurafi Treatment Center, West Armachiho District, Ethiopia, 2009-2015, a retrospective descriptive analysis

Abstract

Introduction: Leishmaniasis currently threatens 350 million men, women and children around the world. Visceral leishmaniasis (VL) is a fatal parasitic disease mostly prevalent in low land areas VL typically affects migrant agricultural workers. Visceral leishmaniasis is caused by the Leishmaniasis donovani complex, which includes Leishmaniasis donovani and Leishmaniasis infantum. An estimated 200,000 to 400,000 new cases of visceral leishmaniasis occur worldwide each year. This study aims to understand the trend, magnitude and mortality of visceral leishmaniasis at MSF Abdurafi treatment center during the period (2009-2015). Methods: Retrospective secondary data analysis was conducted on monthly kala-azar report of MSF Abderafi treatment center in West Armachiho district. We included a total of 11680 patients screened for leishmaniasis in 2009-2015. We entered and analyzed data using Microsoft Excel. Results: Among 11680 patients screened for kalazar in the study period (2009-2015), 2131 were primary kalazar cases, 198 kalazar were relapse and 19 were post kalazar dermal leishmaniasis. The case fatality of kalazar ranged from 0.9% (4/469) in 2014 to 7.4% (22/296) in 2013. The highest cure rate was (96%) in 2015, and the least was (89%) in 2009. The total case fatality rate during study period was 4% (92/2263). The highest HIV/Kala-azar coinfection rate was 15% in 2009 and the lowest was 4.8% in 2014. Conclusion: Visceral leishmaniasis was highly prevalent in the study area. There was high kala-azar mortality rate and majority of deaths were unrecognized. Prevalence rate of VL-HIV co-infection and relapse was higher at MSF Abdurafi kalazar treatment center in West Armachiho district. Ministry of health should strengthen prevention and control mechanisms of kala-azar. Ministry of health and MSF Holland should conduct further studies on the cause of death among kala-azar patients, because there may be drug toxicity or other complications.