02042nas a2200277   4500000000100000008004100001260001200042653001300054653000800067653000900075653001200084653001200096653001500108653001000123100001400133700001700147700001400164700001300178700001400191700001400205245011300219856005000332490000700382520136100389022001401750       2020                            d  c08/202010aEthiopia10aNTD10aWASH10ahygiene10aleprosy10asanitation10awater1 aEmerson L1 aAnantharam P1 aYehuala F1 aBilcha K1 aTesfaye A1 aFairley J00aPoor WASH (Water, Sanitation, and Hygiene) Conditions Are Associated with Leprosy in North Gondar, Ethiopia.  uhttps://www.mdpi.com/1660-4601/17/17/6061/htm0 v173 a<p>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 , 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).  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.</p>  a1660-4601