Factors Associated with Leishmaniases Among Households in Marigat Sub –County of Baringo County, Kenya

Abstract

The global burden of leishmaniases has remained stable for some years, causing a morbidity and mortality mainly to the poor proportion of the population. The global estimate for new cases of visceral leishmaniasis is 500 000 cases per year. In Kenya an estimated 4,000 cases occur annually and five million people are at risk of infection. The overall objective of the study was to assess factors associated with leishmaniases by interviewing household heads in Marigat Sub -County, Baringo County. The specific objectives were to determine the level of knowledge, attitude, perceptions and practices of households towards leishmaniases; the costs and the socio-economic factors associated with leishmaniases in Marigat Sub County. This was a descriptive cross sectional study which used both quantitative and qualitative methods of data collection from households and KII respectively. The study was carried out between November and December 2015 and employed both the probability and non-probability sampling methods. The Marigat Sub County is divided into 17 locations, this study considered three locations (Marigat, Eldume and Loboi) which comprised of 634 households as per the chiefs’ records these formed the sampling frame from which a sample of 423 households was randomly selected. Of the 423 questionnaires administered to the households, 405 were completed giving a response rate of (96%). From each selected household one participant (household head) who voluntary agreed to give informed consent was selected for questionnaire administration. Purposive sampling was used to select key informant interviews participants. Data was analyzed using SPSS version 20 and Stata SE version 13. The Univariate analysis was used to determine proportions and Chi-square was used to determine association between various variables and those which showed P≤0.05, were subjected to multivariate regression analysis at 95% confidence level to test the strength of association. There was a strong evidence of relationship between occupation (P=0.0001), education level (P=0.002), type of the main house (P=0.0001) and the occurrence of leishmaniases. Majority hold the belief that kala azar is more serious than malaria. The mean total expenditure due to kala azar was Kenya shillings 25,983.77($ 259.83) per household. The type of house condition was associated with increase in leishmaniases infection because most respondents were having the houses which favour the breeding and entry of the vectors and this included mud plastered and grass thatched; and stick walled and grass thatched. The stake holders should plan to help the community replace the houses which favour vector breeding and entry with iron corrugated walls and roof which tend to protect the human host. The leishmaniases costs include the direct and indirect costs thus need for interventions to improve access to affordable leishmaniases prevention, diagnosis and treatment. The study shows there are knowledge gaps existing at community level which relate to mode of transmission, seasons kala-azar is prevalent, signs and symptoms of kala-azar and prevention and control strategies. The fear of death seems to be a driving force for seeking medication. The costs of kala-azar management are beyond affordability of poorest households in Marigat therefore the government to consider policy change to either provide free leishmaniases treatment or to subsidize the drug costs.