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Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda

Mueller, Yolanda
Mbulamberi, Dawson B.
Odermatt, Peter
Hoffmann, Axel
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 AdolescentAdultAntiprotozoal Agents/administration & dosage/*adverse effectsChildChild, PreschoolFemale*Hospital MortalityHumansInfantInfant, NewbornLeishmaniasis, Visceral/drug therapy/*mortalityMaleMiddle AgedRetrospective StudiesRisk FactorsTreatment OutcomeUganda/epidemiologyYoung Adult
PMID: 19552645
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Research group Groupe Louis Loutan (médecine des Voyages et des Migrations, Médecine Tropicale, Santé Internationale) (122)
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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

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Deposited on : 2012-04-23

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