Determinants of  Leprosy among patients visiting Sheshamane Comprehensive Specialized Hospital, West Arsi Zone, Oromia Region, Ethiopia: a case-control study

Background Leprosy is still a major public health problem in several countries. It is estimated that several million people worldwide suffer from stigma and leprosy-related permanent physical disability. Despite the World Health Organization's recommended strategy for interrupting transmission, incidence reduction has been minimal in high-burden countries. In the study area, there is a lack of understanding of leprosy transmission risk factors. The study aimed to investigate the determinants of leprosy in patients who visited Sheshamane Comprehensive Specialized Hospital, West Arsi zone, Oromia region. Methods A hospital-based unmatched case-control study was conducted at Sheshamane Comprehensive Specialized Hospital from January to March 2022. Systematic random sampling was used to choose 135 non-leprosy controls (patients with tuberculosis) and 67 patients with confirmed leprosy. An interviewer-administered structured questionnaire was used to gather data. Epi-Info version 7 was used to enter the data, and SPSS version 25 was used for analysis. Binary logistic regression analysis is used to identify risk factors for leprosy. P-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were used to determine statistically significant factors. Result Multivariable analysis showed that a history of contact with a leprosy patient (AOR = 7.3; 95% CI: 3.6, 15.2), living in a rural setting (AOR = 3.13; 95% CI: 1.7, 5.9), food shortage (AOR = 4.2; 95% CI: 2.2, 8.0), and lack of latrine (AOR = 3.9; 95%CI: 1.9, 8.3) were significantly associated with an increased risk of having leprosy. Meanwhile, BCG (Bacillus Calmette-Guerin) immunization (AOR = 0.17; 95% CI: 0.05, 0.57) and good personal hygiene (AOR = 0.35, 95% CI: 0.17, 0.71) were significantly associated with decreasing risk of developing leprosy. Conclusion and recommendations A contact history with leprosy, living in a rural area, having a low monthly income, food shortages, and a lack of a latrine at home were all risk factors for leprosy, while good personal hygiene and BCG vaccination decrease the risk of leprosy. Implementing and enhancing food security in leprosy-endemic areas and providing prompt contact tracing, combined with chemoprophylaxis, is essential.