Identification of environmental parameters and risk mapping of visceral leishmaniasis in Ethiopia by using geographical information systems and a statistical approach.

Visceral leishmaniasis (VL), a vector-borne disease strongly influenced by environmental factors, has (re)-emerged in Ethiopia during the last two decades and is currently of increasing public health concern. Based on VL incidence in each locality (kebele) documented from federal or regional health bureaus and/or hospital records in the country, geographical information systems (GIS), coupled with binary and multivariate logistic regression methods, were employed to develop a risk map for Ethiopia with respect to VL based on soil type, altitude, rainfall, slope and temperature. The risk model was subsequently validated in selected sites. This environmental VL risk model provided an overall prediction accuracy of 86% with mean land surface temperature and soil type found to be the best predictors of VL. The total population at risk was estimated at 3.2 million according to the national population census in 2007. The approach presented here should facilitate the identification of priority areas for intervention and the monitoring of trends as well as providing input for further epidemiological and applied research with regard to this disease in Ethiopia.