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Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda
|Published in||Tropical Medicine & International Health. 2009, vol. 14, no. 8, p. 910-917|
|Abstract||OBJECTIVE: To identify risk factors for in-hospital mortality in patients treated for visceral leishmaniasis (VL) in Uganda. METHODS: Retrospective analysis of VL patients' clinical data collected for project monitoring by Medecins Sans Frontieres in Amudat, eastern Uganda. RESULTS: Between 2000 and 2005, of 3483 clinically suspect patients, 53% were confirmed with primary VL. Sixty-two per cent were children <16 years of age with a male/female ratio of 2.2. The overall case-fatality rate during pentavalent antimonial (n = 1641) or conventional amphotericin B treatment (n = 217) was 3.7%. There was no difference in the case-fatality rate between treatment groups (P > 0.20). The main risk factors for in-hospital death identified by a multivariate analysis were age <6 years and >15 years, concomitant tuberculosis or hepatopathy, and drug-related adverse events. The case-fatality rate among patients >45 years of age was strikingly high (29.0%). CONCLUSION: Subgroups of VL patients at higher risk of death during treatment with drugs currently available in Uganda were identified. Less toxic drugs should be evaluated and used in these patients.|
|Keywords||Adolescent — Adult — Antiprotozoal Agents/administration & dosage/*adverse effects — Child — Child, Preschool — Female — *Hospital Mortality — Humans — Infant — Infant, Newborn — Leishmaniasis, Visceral/drug therapy/*mortality — Male — Middle Aged — Retrospective Studies — Risk Factors — Treatment Outcome — Uganda/epidemiology — Young Adult|
|Research group||Groupe Louis Loutan (médecine des Voyages et des Migrations, Médecine Tropicale, Santé Internationale) (122)|
|MUELLER, Yolanda et al. Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda. In: Tropical Medicine & International Health, 2009, vol. 14, n° 8, p. 910-917. doi: 10.1111/j.1365-3156.2009.02305.x https://archive-ouverte.unige.ch/unige:19989|