Re-emergence and influencing factors of mountain-type zoonotic visceral leishmaniasis in the extension region of Loess Plateau, China

PLoS Negl Trop Dis. 2024 May 31;18(5):e0012182. doi: 10.1371/journal.pntd.0012182. eCollection 2024 May.

Abstract

Objective: To understand the epidemiological distribution characteristics of mountain-type zoonotic visceral leishmaniasis (MT-ZVL) in Yangquan City, Shanxi Province, China, from 2006 to 2021, to explore the influencing factors leading to the re-emergence of the epidemic, and to provide a basis for the formulation of targeted control strategies.

Methods: Case information spanning from 2006 to 2021 in Yangquan City was collected for a retrospective case-control study conducted from June to September 2022. A 1:3 matched ratio was employed. A questionnaire was utilized to gather data on basic information, demographic characteristics, awareness of MT-ZVL knowledge, residence, and dog breeding and living habits. The study employed a multifactorial conditional stepwise logistic regression model to analyze the influencing factors.

Results: A total of 508 subjects was analyzed. Risk factors for MT-ZVL included the use of soil/stone/concrete as building materials (OR = 3.932), presence of nearby empty/stone stack houses (OR = 2.515), dog breeding (OR = 4.215), presence of stray dogs (OR = 2.767), and neighbor's dog breeding (OR = 1.953). Protective factors comprised knowledge of MT-ZVL (OR = 0.113) and using mosquito repellents (OR = 0.388). The findings indicate significant associations between environmental and behavioral factors and MT-ZVL incidence in Yangquan City, Shanxi Province, China, from 2006 to 2021. These results underscore the importance of public awareness campaigns and targeted interventions aimed at reducing exposure to risk factors and promoting protective measures to mitigate the re-emergence of MT-ZVL outbreaks.

Conclusion: House building materials, presence of neighboring empty houses, breeding domestic dogs and distribution of stray dogs surrounding the home are risk factors for MT-ZVL. Awareness of MT-ZVL and implementation of preventive measures during outdoor activities in summer and autumn are protective and may reduce the risk of MT-ZVL.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Case-Control Studies
  • Child
  • Child, Preschool
  • China / epidemiology
  • Dog Diseases / epidemiology
  • Dog Diseases / parasitology
  • Dog Diseases / transmission
  • Dogs
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Leishmaniasis, Visceral* / epidemiology
  • Leishmaniasis, Visceral* / prevention & control
  • Leishmaniasis, Visceral* / transmission
  • Male
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Surveys and Questionnaires
  • Young Adult
  • Zoonoses* / epidemiology
  • Zoonoses* / transmission

Grants and funding

This work was supported by the National Key Research and Development Program of China (No. 2021YFC2300800, 2021YFC2300803); the National Natural Science Foundation of China (No. 32161143036, 32311540013); the International Joint Laboratory on Tropical Diseases Control in Greater Mekong Subregion (no. 21410750200) and the Shanxi Provincial Health Commission Project (2021021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.