The epidemiology of human visceral leishmaniasis in El Agamy (Alexandria Governorate), Egypt: serosurvey and case/control study

In Alexandria Governorate, Egypt, 27 cases of visceral leishmaniasis (VL) were detected from 1982-1985 through active and passive case detection. Twenty-two were located in El Agamy, a resort town of 50,000 residents located 15 km west of the City of Alexandria. To describe the disease focus, eight areas of 100-200 households in El Agamy were mapped and censused. All individuals were examined clinically, and blood was obtained by finger stick to measure leishmanial antibodies by radioimmune assay. Two case/control studies were carried out in the mapped areas. In one study, case households were more often found near open garbage containers than were control households. In a second case/control study, houses with cases of VL or seropositive individuals were found more likely to face open areas. These results demonstrate that characteristics of houses which could increase exposure to reservoir hosts can be associated with VL or leishmanial seropositivity. This suggests that control programmes should improve garbage disposal and should focus on houses located in peripheral areas of the community.