Abstract:
Background: Visceral Leishmaniasis (Kala-azar) is a serious disease caused by species of the parasitic protists Leishmania. It can affect humans living in parts of the tropics and sub-tropics and is transmitted by Phlebotomus sandflies. It is classified as a neglected disease yet it is a public health problem, a debilitating disease causing an estimated 500,000 new cases each year, and a tenth of these patients will die in the predisposed areas. Objective: To assess the exposure factors associated with kala-azar in Loima sub-county of Turkana County, Kenya. Methods: Descriptive cross- sectional research design was employed and the study was conducted between October, 2015 and June, 2016. Cluster random sampling technique was used to identify study subjects in the purposively selected Loima Sub-county. A sample size of 341 respondents who were household heads or adult members and health facility workers were randomly sampled. Data collection was done using pretested structured questionaires, interviews, focus group discussions and observations; entered into Statistical Package for Social Sciences (SPSS) version 17.0 for analysis. Presentation of data was done using both quantitative and qualitative approaches. Results: The key exposure factors to the disease in the community include: Age, gender, educational level, socio-economic status, housing, presence of large amount of termite mounds all over the area 60.1%(n=205),inaccessibility to health services, varying health-seeking behaviour and lack of proper knowledge on transmission of disease. Also, human activities such as deforestation and hunting 52%(n=32), resting or sitting near termite mounds 70%(n=191) and dancing at night (Edong’a -64.8%(n=167), when the sand flies are active. There was a significant association between age ((OR=0.7; 95%CI= (0.4-1.1), p=0.135) and exposure to kala-azar, gender (OR=0.6; 95%CI= (0.4-0.9), p=0.012),education level (OR=1.2; 95%CI= (0.1-1.4), p=0.0501)), housing (OR=1.8; 95%CI= (1.0-3.1), p=0.029 ),presence of large amount of termite mounds (OR=0.6; 95%CI= (0.2-2.0), p=0.0045) and resting or sitting near termite-mounds (OR=0.6; 95%CI= (0.1-2.1), p=0.0043)).Conclusion: The study concludes that kala-azar is prevalent in the area and though the community is aware of its existence, the residents have different beliefs about transmission. The study recommends the need for enhanced general health education and awareness on the transmission cycle of kala-azar. Community empowerment and participation should be emphasized as well as structural development plans that include sand fly management strategies and control methods that would ensure the removal of breeding and resting sites of the vectors within human habitation. In addition, integrated disease surveillance and response to be implemented to avert the disease situation.
