title: [Visceral leishmaniasis: retrospective study on factors associated with lethality].
abstract: BACKGROUND
  Visceral leishmaniasis is a public health problem, with lethality reaching 10%. The recommended drug treatment is methylglucamine antimoniate. This study aimed to evaluate drug use for cases of visceral leishmaniasis treated at the Infectology Clinic of the Campo Grande University Hospital Center, State of Mato Grosso do Sul.
  
  
  METHODS
  To collect data, we examined the medical records of 76 patients with a diagnosis of visceral leishmaniasis treated at this Infectology Clinic.
  
  
  RESULTS
  The medical files of 76 patients (56 men and 20 women; 28.9%) showed comorbidities. The first choice drug for 88.2% of the patients was N-methylglucamine antimoniate, with a fatal outcome for 18.4%. Survival analysis showed a statistically significant difference between patients with and without comorbidities (p <0.0001) and with comorbidities who used Glucantime (p < 0.0009). The fatality rate of 18.4% indicates the low efficiency of the healthcare measures used.
  
  
  CONCLUSIONS
  The results suggest that the prognosis becomes poor when associated with the presence of comorbidities, and that the treatment needs to be carefully administered to minimize mortality.
authors.affiliation: Departamento de Patologia, Universidade Vale do Rio Doce, Governador Valadares, MG. daniel_alvarenga@hotmail.com
authors.forename: Daniel Gomes de
authors.initials: DG
authors.lastname: Alvarenga
authors.forename: Patrícia Maria Fonseca
authors.initials: PM
authors.lastname: Escalda
authors.forename: Alexandre Sylvio Vieira da
authors.initials: AS
authors.lastname: Costa
authors.forename: Maria Tereza Ferreira Duenhas
authors.initials: MT
authors.lastname: Monreal
mesh_terms: D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000188:drug therapy* / Q000401:mortality*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000666:Amphotericin B