title: Risk factors for relapse of visceral leishmaniasis in Georgia.
abstract: The number of relapses in patients treated for visceral leishmaniasis (VL) has increased, thus identifying prognostic factors may aid decisions on treatment. Demographic and clinical information was abstracted from medical records of patients diagnosed and treated in Georgia from 2002 to 2004. The 300 persons with VL were primarily children <5 years (73.3%), and ∼44% had delays in diagnosis of more than 30 days from symptom onset. All patients received standard therapy with pentavalent antimony (20 mg/kg/day), most for 20-25 days. Factors significantly associated with VL relapse were delay in diagnosis for >90 days (RR = 4.21, 95% CI: 1.58, 11.16), haemoglobin level <60 g/l (RR = 11.96, 95% CI: 4.12, 34.76) and age <1 year (RR = 2.36, 95% CI: 0.96, 5.80). Physician and public education is needed to reduce delays in diagnosis. Prolonging treatment for 30 days (e.g. WHO recommendation) or implementing new regimens may reduce the number of relapses.
authors.affiliation: Maternal and Child Care Union, Tbilisi, Georgia. maiakajaia@yahoo.com
authors.forename: Maia
authors.initials: M
authors.lastname: Kajaia
authors.forename: Dale L
authors.initials: DL
authors.lastname: Morse
authors.forename: George
authors.initials: G
authors.lastname: Kamkamidze
authors.forename: Maia
authors.initials: M
authors.lastname: Butsashvili
authors.forename: Giulen
authors.initials: G
authors.lastname: Chubabria
authors.forename: Otar
authors.initials: O
authors.lastname: Zenaishvili
authors.forename: Nora
authors.initials: N
authors.lastname: Kokaia
authors.forename: Louise-Anne
authors.initials: LA
authors.lastname: McNutt
mesh_terms: D000367:Age Factors; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008536:Meglumine / Q000627:therapeutic use; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000627:therapeutic use; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000981:Antiprotozoal Agents; D006454:Hemoglobins; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate