Mobile workers in north Ethiopia vulnerable to visceral leishmaniasis transmission

November 8, 2018, Public Library of Science
Bone marrow aspiration: Leishmaniasis (Leishmania sp.) in liver transplant recipient. Credit: Paulo Henrique Orlandi Mourao, CC BY-SA 3.0

Visceral leishmaniasis (VL) is a life-threatening disease transmitted by the bite of a sand fly. Between 3,700 to 7,400 people in Ethiopia are infected annually, particularly in the northern, agricultural regions with favorable climate and environment to sand fly vectors. A study published in PLOS Neglected Tropical Diseases by Rebecca Coulborn from Epicentre, France, and colleagues suggests that transitory populations in Ethiopia may be particularly vulnerable to acquisition of and death from VL infections.

Without treatment, VL is nearly always fatal and may increase risk of transmission to others. Using qualitative methods, researchers endeavored to learn more about mobile workers' exposure to VL and obstacles to diagnosis and treatment. A sample of mobile workers, VL patients, community leaders and healthcare workers participated in focus groups and in-depth interviews to discuss VL in mobile populations, including questions regarding risk and healthcare access.

The authors found that mobile workers faced exposure to sand flies, due to sleeping outside and inconsistent use of protective clothing and bed netting in VL endemic areas. Once infected with VL, symptoms could be misdiagnosed or undetected due to a lack of diagnostic test kits available in rural health centers. Although the research sample comprised only 137 participants, it is the first of its kind in Ethiopia. The researchers suggest their results may lead to interventions tailored to the particular needs of mobile populations and others at risk for VL: "Our results may offer strategies allowing for earlier diagnoses and better prognoses for VL patients."

Explore further: Treating dogs with insecticide reduces leishmaniasis transmission in human populations

More information: Coulborn RM, Gebrehiwot TG, Schneider M, Gerstl S, Adera C, et al. (2018) Barriers to access to visceral leishmaniasis diagnosis and care among seasonal mobile workers in Western Tigray, Northern Ethiopia: A qualitative study. PLOS Neglected Tropical Diseases 12(11): e0006778. doi.org/10.1371/journal.pntd.0006778

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