Prevalence of kala-azar infection in Pokot county, Amudat district, Northeastern Uganda

Introduction: Visceral leishmaniasis (kala-azar) caused by Leishmania donovani and transmitted by the sand-fly Phlebotomus martini is endemic in certain foci in north-eastern Uganda where it is thought to be confined to Pokot county, Amudat district. Amudat hospital records (April 1998-March 1999) indicated that kala-azar accounted for about 17% of hospital in-patients. However the actual prevalence of kala-azar infection in the community in Pokot county is unknown. This lack of information limits efforts geared towards its control. Objective: To determine the prevalence of kala-azar infection in Pokot county. Methods: A cross-sectional study was conducted in Pokot county in March 2010. The study participants were ≥ 5 years and were randomly selected from the age and sex strata in the chosen clusters. A questionnaire that elicited demographic profiles of participants was used for data collection. Standard procedure for direct agglutination test using blood samples collected from participants on blotting papers was performed. Data was entered in EPIINFO 3.3 and exported to STATA 10, where descriptive statistics were generated. Results: The overall prevalence of kala-azar infection in Pokot county was 17.2% but the prevalence of symptomatic infection in the community was 2.5%. The ratio of symptomatic to asymptomatic kala-azar was 1:6. Loroo sub-county had the highest prevalence of kala-azar infection followed by Karita and Amudat sub-counties at 31.9%, 14.6% and 5.3%, respectively. Conclusion: With kala-azar infection prevalence at 17.2% in the community, there is an urgent need to institute control program spearheaded by ministry of health, in the region. Furthermore, recent reports of cases from other districts within the region, the heterogeneous distribution of infection within the county and the current risk factors, including the role of animals in kala-azar transmission in this area need to be evaluated.