Association of parasitic coinfection with clinical leprosy in Addis Ababa Ethiopia Open Access
Getachew, Liya Sisay (Spring 2024)
Abstract
Background: Leprosy is among the neglected tropical diseases that is marked for elimination by WHO. There is still much that needs to be done to understand the mechanisms of transmission and risk factors for development of leprosy. This study assessed the association of parasitic coinfection, Water, Sanitation and Hygiene (WASH) practices and selected environmental factors with leprosy in the All Africa Leprosy Rehabilitation and Training Center (ALERT) in Addis Ababa, Ethiopia.
Methods: A case control study design was used. Leprosy cases were selected from Leprosy clinics in ALERT, and controls were Anti-PGL 1 antibody negative participants selected from a seroprevalence study. A standardized questionnaire was administered to each participant followed by the collection of stool samples to test for the presence of parasitic infections.
Results: A total of 240 participants, 54 cases and 186 controls, were enrolled. The mean age of was 42 years (SD 17 years) and there was 43% men and 57% women. Notably, men represented 65% of the cases. There were no helminth infections found among participants. Protozoal infections such as Entamoeba Histolytica and Giardia Lamblia were identified in a total of 38 participants, but this did not yield a significant association with leprosy in both univariate and multivariate analysis [OR= 1.08, 95% CI (0.46, 2.38)]. In addition, poor WASH practices were found to be associated with leprosy. In multivariate analysis, unimproved sanitation [aOR= 13.1, 95% CI (3.46, 57.2)], lack of direct drinking water [aOR= 5.22, 95% CI (1.50, 19.3)], exposed dirt flooring [aOR= 6.93, 95% CI (1.94, 31.0)], were significantly associated with leprosy. Lack of hand soap did not show a statistically significant association in the multivariate analysis but still maintained a positive directionality [aOR= 4.26, 95% CI (0.30, 54.7)].
Conclusion: The findings of this study suggest that a complex interplay between host and environmental factors may contribute to the transmission and susceptibility to leprosy. While the insights gained can improve our understanding and inform preventive strategies, the study emphasizes the need for a more comprehensive assessment of additional host factors, such as nutritional status, and environmental influences.
Table of Contents
Introduction 1
Literature Review 2
Materials and Methods 8
Results 11
Discussion 17
Conclusion 21
Public Health Implication 21
References 22
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