Factors associated with visceral leishmaniasis in Nepal: bed-net use is strongly protective

Am J Trop Med Hyg. Sep-Oct 2000;63(3-4):184-8. doi: 10.4269/ajtmh.2000.63.184.


Since 1980, visceral leishmaniasis (VL) has reemerged as a public health problem in lowland Nepal. We conducted a case-control study to identify risk factors. In univariate analyses among 84 cases and 105 controls, protective factors included sleeping on a bed or cot (Odds ratio [OR] 0.44, P < 0.01) and sleeping under a bed-net regularly (OR 0.23, P < 0.001) or in the warm months (OR 0.20, P < 0.001). The bed-nets in use in this region were commercially available and untreated with insecticide. Ownership of a cow or buffalo was protective (OR 0.34, P < 0.001), whereas dampness observed in the mud floor of the house was a strong risk factor (OR 4.0, P < 0.001). In multivariable models, bed-net usage, cow or buffalo ownership, and damp floors were significantly associated with altered risk. A program to increase bed-net usage could therefore decrease the incidence of VL in Nepal.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Bedding and Linens*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Leishmaniasis, Visceral / epidemiology*
  • Leishmaniasis, Visceral / prevention & control*
  • Male
  • Nepal / epidemiology
  • Risk Factors