Burden and risk factors of cutaneous leishmaniasis in Ethiopia: a systematic review and meta-analysis

Introduction Cutaneous leishmaniasis (CL) is a major public health problem in Ethiopia. About 30 million people are at risk, and there are 20,000 to 50,000 new cases annually. It is maintained by rock hyraxes and Phlebotomus sand flies. Different studies showed the presence and risk factors of CL. However, there is no study on the pooled prevalence and risk factors. This study aimed to determine the pooled prevalence and risk factors of CL in Ethiopia. Method We retrieved published articles from different databases. The review was conducted based on PRISMA guidelines. The meta-analysis was done with Stata software version 14. The forest plot with random-effect model and inverse variance index was used to estimate the pooled prevalence with 95% confidence interval and heterogeneity of articles, respectively. Results A total of 99,226 people from 19 studies were screened. The overall pooled prevalence of CL was 20.4% with 95% CI (15.67-25.13%). The pooled prevalence is a weighted average of results of the included 19 studies. Highest pooled prevalence, 65.39% (95% CI: 61.14-69.47%), was in Southern Nations, Nationalities and Peoples' Region (SNNPR), and the lowest was 1.53% (95% CI: 1.43-1.63%) in Amhara Region. Children were the most affected age group. Living in a home close to farmlands, outdoor sleeping behavior, the presence of gorge, hyrax, cracked walls, animal dung, and other cases in the neighborhood were identified as risk factors for CL. Conclusion There is high burden of CL in Ethiopia. Larger surveys are required. Health education on the prevention and control strategies shall be implemented.