Assessing Risk Factors for Visceral Leishmaniasis Outbreak in South Omo Zone, Southern Ethiopia: Implications for Tailored Intervention Strategies

Abstract

Background: Visceral leishmaniasis (VL) is a severe, life-threatening public health concern in Ethiopia. Since early 2022, the outbreak of VL in the South Omo Zone, particularly among pastoralist communities, has resulted in multiple deaths. Objective: To assess the risk factors contributing to the VL outbreak in South Omo Zone, southern Ethiopia. Methods: A mixed-method study was conducted in Hammer, Nyangatom, and Selamago districts (areas with the highest case load). The study included a stakeholder consultative workshop and qualitative interviews with health workers, community leaders, and caregivers. A matched case-control study was also performed, and conditional logistic regression was used to analyze quantitative data. Findings: The stakeholder consultation revealed 64 challenges linked to the outbreak. The top-ranked challenge was the high non-medical cost of VL diagnosis and treatment, followed by limited government and stakeholder commitment. Notably, the absence of governmental structure in the Mursi area (Selamago district) was identified as a significant barrier despite being ranked 11th. Qualitative data highlighted additional challenges: poor transportation, distant treatment services, low awareness, cultural treatment practices, and lengthy therapy duration. Quantitatively, family history of VL was a significant risk factor (AOR = 2.91, 95% CI: 1.73–4.87), while VL cases were more likely to have good knowledge of the disease than controls (AOR = 6.6, 95% CI: 2.34–18.42). Conclusion: The findings highlight significant challenges in the control and management of visceral leishmaniasis (VL) in South Omo Zone, including high non-medical costs of care, limited government commitment, inadequate outbreak preparedness, and shortages of trained providers. Prioritized strategies emphasized strengthening health systems, mobilizing resources, and engaging political and community leaders. Addressing systemic gaps and strengthening community-based interventions are essential for effective VL outbreak control and timely treatment.