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Review
. 2021 Mar;10(1):47-60.
doi: 10.1007/s40121-020-00361-y. Epub 2020 Nov 10.

Prevalence and Risk Factors of Human Leishmaniasis in Ethiopia: A Systematic Review and Meta-Analysis

Mekonnen Haftom  1 , Pammla Petrucka  2 , Kbrom Gemechu  3 , Jemila Nesro  4 , Embay Amare  5 , Tsegu Hailu  3 , Yohannes Ashebir  3 , Gdiom Gebreheat  3 , Haftea Hagos  3 , Destaalem Gebremedhin  3 , Alem Gebremariam  5
Affiliations
Review

Prevalence and Risk Factors of Human Leishmaniasis in Ethiopia: A Systematic Review and Meta-Analysis

Mekonnen Haftom et al. Infect Dis Ther. 2021 Mar.

Abstract

Introduction: Tropical diseases are public health problems affecting hundreds of millions of people globally. However, the development of adequate, affordable, and accessible treatments is mostly neglected, resulting in significant morbidity and mortality that could otherwise be averted. Leishmaniasis is one of the neglected tropical diseases caused by the obligate intracellular protozoan Leishmania parasite and transmitted by the bite of infected phlebotomine sandflies. No systematic review and meta-analysis has been done to identify the prevalence and risk factors of leishmaniasis to the authors' knowledge. Therefore, the objective was to determine the prevalence and risk factors of human leishmaniasis in Ethiopia.

Methods: Eleven studies conducted in all regions of Ethiopia, which were fully accessible, written in any language, and original articles done on prevalence and risk factors of leishmaniasis, were included. STATA™ version 11.1 was used for statistical analysis. Chi-square, I2, and p values were assessed to check heterogeneity. A random effects model with heterogeneity taken from an inverse-variance model was employed to estimate the pooled effect. Subgroup meta-analysis was computed to reduce random variations among each article's point prevalence, and Egger and funnel plots were used to check for publication bias.

Results: The highest proportion of human leishmaniasis was reported from a study done in Amhara region (39.1%), and the lowest was reported from a survey done in Tigray (2.3%). The overall pooled prevalence of leishmaniasis was 9.13% (95% CI 5-13.27). Subgroup analysis by region revealed moderate heterogeneity (I2 = 51.8%) in studies conducted in the Southern Nations Nationalities and Peoples Region (SNNPR). The presence of hyraxes and being male were associated with an increased risk of human leishmaniasis.

Conclusion: The prevalence of leishmaniasis in Ethiopia remains high (9.13%), with significant risk factors being male and the presence of hyraxes within a 300-m radius of the sleeping area.

Keywords: Ethiopia; Infectious disease; Leishmaniasis; Neglected tropical diseases; Prevalence.

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Figures

Fig. 1
Fig. 1
PRISMA flowchart showing the number of articles identified in the systematic review and meta-analysis on the prevalence of human leishmaniasis and associated factors
Fig. 2
Fig. 2
Forest plot of pooled prevalence of human leishmaniasis in Ethiopia
Fig. 3
Fig. 3
Subgroup meta-analysis by type of human leishmaniasis in Ethiopia
Fig. 4
Fig. 4
Funnel plot showing a risk of bias on leishmaniasis prevalence and standard error in Ethiopia
See this image and copyright information in PMC

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