1.1 Introduction
Leishmaniasis is a vector-borne parasitic disease caused by protozoa of the genus Leishmania, which is transmitted to humans through the bite of infected female phlebotomine sandflies. The disease exists in several clinical forms, including cutaneous, mucocutaneous, and visceral leishmaniasis, with visceral leishmaniasis being the most severe as it is associated with systemic infection and high mortality if untreated (World Health Organization, 2023). In Nigeria, leishmaniasis remains a significant but underreported public health concern, especially in rural communities where socio-economic and environmental conditions is favorable for disease transmission. The disease is further exacerbated by limited diagnostic capacity and low awareness among the population, leading to delayed treatment and sustained transmission within affected areas (Okwor & Uzonna, 2016).
The epidemiology of leishmaniasis in rural Nigerian settings is influenced by multiple interconnected factors, including environmental changes such as deforestation, agricultural expansion, and climate variability, which alters vector distribution and density. Human behavioral patterns such as outdoor sleeping, farming activities during peak sandfly biting hours, and inadequate use of protective measures also contributes significantly to transmission risk (Alvar et al., 2012).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Leishmaniasis is a parasitic disease caused by protozoa of the genus Leishmania, transmitted to humans through the bite of infected female phlebotomine sandflies. According to the World Health Organization (2023), the disease manifests in three main forms, namely cutaneous, mucocutaneous, and visceral leishmaniasis, with visceral leishmaniasis being the most severe form because it affects internal organs such as the spleen, liver, and bone marrow, and is often fatal if untreated. The disease remains one of the neglected tropical diseases that disproportionately affects populations living in poverty, especially in rural and peri-urban communities where environmental and socio-economic conditions support vector survival and disease transmission.
According to Alvar et al. (2012), leishmaniasis continues to pose a global public health challenge with millions of people at risk of infection, particularly in tropical and subtropical regions. Alvar et al. reported that the burden of the disease is strongly associated with poverty-related factors such as inadequate housing, malnutrition, limited access to healthcare services, and poor environmental sanitation.
In the African context, the disease is less reported compared to other regions such as South Asia and South America; however, according to van Griensven and Diro (2019), Africa bears a significant burden of visceral leishmaniasis, especially in countries within the East African region. The authors asserted that underreporting, misdiagnosis, and weak surveillance systems contribute to the underestimation of the true burden of the disease across the continent. In Nigeria, leishmaniasis is increasingly recognized as an emerging but neglected public health issue in several rural communities. According to Okwor and Uzonna (2016), rural populations are particularly vulnerable due to their close interaction with the natural environment, where sandflies breed in cracks, rodent burrows, and organic waste materials.
Okwor and Uzonna reported that human activities such as farming, hunting, and outdoor sleeping increase exposure to sandfly bites, thereby increasing the risk of infection. They further stated that socio-economic deprivation, including low income levels and poor education, limits awareness and prevention practices in affected communities. According to Reithinger et al. (2007), ecological changes such as deforestation, agricultural expansion, and unplanned urbanization contribute to the alteration of sandfly habitats and increase human-vector contact. The authors affirmed that climate variability, including changes in temperature and rainfall patterns, influences sandfly population density and distribution, thereby affecting seasonal transmission patterns of the disease.
Koltas et al. (2014) asserted that, the persistence of leishmaniasis in endemic regions is strongly linked to weak health systems and limited access to diagnostic and treatment services. Koltas et al. reported that in many rural settings, patients often rely on traditional medicine due to the high cost of healthcare services and long distances to health facilities. In Nigeria, the role of research institutions such as the Leishmaniasis Research Group Nigeria is increasingly important in addressing gaps in knowledge and improving understanding of disease transmission patterns. This study is set against the backdrop of the persistent burden of leishmaniasis in Nigerian rural communities, the limited availability of localized epidemiological data, and the need to generate evidence that will support targeted and effective disease control strategies.
1.3 Statement of Problems
Investigation revealed that many affected individuals in rural Nigeria rely on traditional medicine due to cost barriers and lack of awareness, which often results in disease progression and complications before clinical intervention is sought (Alvar et al., 2012). In Nigeria, rural communities are often characterized by poor housing conditions, overcrowding, and proximity to animal reservoirs and sandfly breeding sites, all of which is associated with increased transmission risk. Agricultural practices and outdoor sleeping habits further expose individuals to vector bites, especially during evening and night hours when sandflies is most active (WHO, 2023; Okwor & Uzonna, 2016).
Furthermore, environmental changes such as deforestation, urban expansion into rural settlements, and climate variability is influencing the distribution and density of sandfly populations, thereby increasing human-vector contact in previously less affected areas. It is against this backdrop that this study seeks to examine the risk factors for leishmaniasis in Nigerian rural communities, with a focus on generating evidence that is useful for improving prevention, control, and policy response strategies.
1.4 Aim and Objectives of Study
The aim of this study is to investigate the risk factors for leishmaniasis in Nigerian rural communities. To achieve this aim, the study has the following objectives:
- To identify environmental factors contributing to leishmaniasis transmission in Nigerian rural communities.
- To assess socio-economic conditions influencing exposure to leishmaniasis in rural populations.
- To examine behavioral practices that increase the risk of sandfly bites among rural residents.
- To evaluate the level of awareness and knowledge of leishmaniasis in rural communities.
- To determine the role of Leishmaniasis Research Group Nigeria in disease surveillance and control activities.
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