Prevalence of kala-azar infection in Pokot county, Amudat district, Northeastern Uganda

Abstract

Introduction: Visceral leishmaniasis (kala-azar) caus-ed by Leishmania donovani and transmitted by the sand-fly Phlebotomus martini is endemic in certain foci in north-eastern Uganda where it is thought to be confined to Pokot county, Amudat district. Amudat hospital records (April 1998-March 1999) indicated that kala-azar accounted for about 17% of hospital in-patients. However the actual prevalence of kala-azar infection in the community in Pokot county is unknown. This lack of information limits efforts gear-ed towards its control. Objective: To determine the prevalence of kala-azar infection in Pokot county. Methods: A cross-sectional study was conducted in Pokot county in March 2010. The study participants were ≥ 5 years and were randomly selected from the age and sex strata in the chosen clusters. A question-naire that elicited demographic profiles of partici-pants was used for data collection. Standard proce-dure for direct agglutination test using blood samples collected from participants on blotting papers was performed. Data was entered in EPIINFO 3.3 and ex-ported to STATA 10, where descriptive statistics were generated. Results: The overall prevalence of kala-azar infection in Pokot county was 17.2% but the pre-valence of symptomatic infection in the community was 2.5%. The ratio of symptomatic to asymptomatic kala-azar was 1:6. Loroo sub-county had the highest prevalence of kala-azar infection followed by Karita and Amudat sub-counties at 31.9%, 14.6% and 5.3%, respectively. Conclusion: With kala-azar infection pre-valence at 17.2% in the community, there is an urgent need to institute control program spearheaded by mi-nistry of health, in the region. Furthermore, recent re-ports of cases from other districts within the region, the heterogeneous distribution of infection within the county and the current risk factors, including the role of animals in kala-azar transmission in this area need to be evaluated.