Prognostic factors for death from visceral leishmaniasis in Teresina, Brazil.
BACKGROUND
A possible strategy to reduce fatality rates of visceral leishmaniasis is to identify prognostic factors that can be easily assessed and used as an aid to clinical decision-making.


METHODS
A case-control study was developed in Teresina, Brazil, in which cases were patients who died during treatment (n = 12) and controls (n = 78) comprised a random sample of patients who were alive when treatment was finished.


RESULTS
Variables significantly associated with death were severe anemia, fever for more than 60 days, diarrhea and jaundice. The prognostic system had a sensitivity of 85.7% and a specificity of 92.5%.


CONCLUSIONS
The prognostic model developed in this study had satisfactory performance and might be useful in developing countries, since it is simple and inexpensive. However, it is still preliminary and needs to be improved and validated using larger and more recent samples.
Werneck
G L
GL
Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524, 7 andar, Bloco D, Maracanã, RJ-20559-900 Rio de Janeiro, Brazil. gwerneck@malaria.procc.fiocruz.br
Batista
M S A
MS
Gomes
J R B
JR
Costa
D L
DL
Costa
C H N
CH
D000293:Adolescent; D000328:Adult; D000818:Animals; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007893:Leishmania donovani / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D016019:Survival Analysis