title: Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda.
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%).
  
  
  CONCLUSIONS
  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.
authors: Médecins Sans Frontières, Geneva, Switzerland. yolanda.muller@geneva.msf.org
authors: Yolanda
authors: Y
authors: Mueller
authors: Dawson B
authors: DB
authors: Mbulamberi
authors: Peter
authors: P
authors: Odermatt
authors: Axel
authors: A
authors: Hoffmann
authors: Louis
authors: L
authors: Loutan
authors: François
authors: F
authors: Chappuis
mesh_terms: D000293:Adolescent; D000328:Adult; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007898:Leishmaniasis, Visceral / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014454:Uganda / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents