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Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda | Journal Article / Research | MSF Science Portal
Journal Article
|Research

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

Mueller YK, Mbulamberi DB, Odermatt P, Hoffmann A, Loutan L, Chappuis F
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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 Médecins Sans Frontières 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.

Countries

Uganda

Languages

English
Published Date
11 Aug 2009
Journal
Tropical Medicine and International Health
Volume | Issue | Pages
Volume 14, Issue 8, Pages 910-917
Issue Date
2009-08-01