Poor WASH (Water, Sanitation, and Hygiene) Conditions Are Associated with Leprosy in North Gondar, Ethiopia

Lisa E. Emerson, Puneet Anantharam, Feleke M. Yehuala, Kassahun D. Bilcha, Annisa B. Tesfaye and Jessica K. Fairley
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Lisa E. Emerson: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Puneet Anantharam: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
Feleke M. Yehuala: College of Medicine and Health Sciences, University of Gondar, P.O. Box 196 Gondar, Ethiopia
Kassahun D. Bilcha: School of Medicine, Emory University, Atlanta, GA 30322, USA
Annisa B. Tesfaye: College of Medicine and Health Sciences, University of Gondar, P.O. Box 196 Gondar, Ethiopia
Jessica K. Fairley: Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA

IJERPH, 2020, vol. 17, issue 17, 1-10

Abstract: Access to safe water, sanitation, and hygiene (WASH) is critical for preventing the spread of neglected tropical diseases (NTDs) including leprosy. WASH-related transmission factors remain largely unexplored in the leprosy transmission cycle. The aim of this project is to better understand WASH exposures among leprosy cases through a case-control study in North Gondar, Ethiopia. We hypothesized that leprosy cases were more likely to have inadequate WASH access and were more likely to have concurrent schistosomiasis, as schistosomiasis immune consequences may facilitate leprosy infection. Forty leprosy cases (forty-one controls) were enrolled, tested for Schistosoma mansoni , administered a demographic and WASH survey, and assigned a WASH index score. WASH factors significantly associated with leprosy on adjusted analyses included open defecation (aOR = 19.9, 95% CI 2.2, 176.3) and lack of access to soap (aOR = 7.3, 95% CI 1.1, 49.9). S. mansoni was detected in 26% of participants and in stratified analysis those with leprosy had a 3.6 (95% CI (0.8, 15.9)) greater odds of schistosomiasis in districts bordering the lake, compared to 0.33 lower odds of schistosomiasis in districts not bordering the lake (95% CI (0.09, 1.2)). Overall, results suggest that leprosy transmission may be related to WASH adequacy and access as well as to schistosomiasis co-infection.

Keywords: leprosy; NTD; WASH; water; sanitation; hygiene; Ethiopia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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