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Outbreak investigation of Visceral Leishmaniasis in Borena Zone, Oromia Region, Ethiopia, November 2019: Case Control study

Abstract Visceral Leishmaniasis (VL) is a protozoan disease caused by Leishmania parasites that infect mammals transmitted by Phlebotomine sand-flies and mostly affects the poorest. VL distributed worldwide and prevalent in Ethiopia particularly in six regions. Knowing the occurrence of the disease and risk factor is a remedy for prevention and control. The aim of study was to identify factors associated with VL. Case control was carried out during October-November 2019 in Borena. A 1:2 Cases and controls were identified by case definition and 33 cases were included in the study. Participants >18years interviewed and caregivers of <18 were questioned. Epi-info and SPPS were used for data entry and analysis. Primarily predictors were identified using chi-square at significant level P<0.05 with 95%CI, then candidate predictors were analysed using bivariate and multivariate analysis to identify associated factors. Among 153 suspected cases, 9 suspected deaths reported; 33 (22%) cases and 3 deaths were verified for VL. Among 33 verified cases 15(45.5%) were in July 2019, in comparison of 4years data, there is surge cases in July-August 2019, 26(79%) of cases were from Dire, AR=15/100,000, CFR=1.4/100,000. Among all, 15-64year were highly affected with AR=19.3. A case control engaged 99(100%) respondents and among all 93(93.9%) were male, 68(68.8%) were 15-64years. Adult education AOR=30.438(2.378,389.602), bed-net AOR=9.024 (1.763,46.205) and walling AOR=0.052(0.004,0.739) were associated factors with VL at 95%CI with p-value<0.05. Male 15-64years were highly susceptible. Level of education, ITNs and walling were associated factors with VL. Formulating policies and guidelines pastoralists related vector control and awareness creation regarding feeding habit of sand fly, prevention and control were recommended. Awareness of community on prevention method; using repellents, ITNs utilization, and safe sleeping mechanisms are mandatory. Further investigation on the issue is best remedy to overcome future VL outbreak occurrence.