Risk Factors for Death from Visceral Leishmaniasis in an Urban Area of Brazil.
BACKGROUND
Over the last three decades, the epidemiological profile of visceral leishmaniasis (VL) has changed with epidemics occurring in large urban centers of Brazil, an increase in HIV/AIDS co-infection, and a significant increase in mortality. The objective of this study was to identify the risk factors associated with death among adult patients with VL from an urban endemic area of Brazil.


METHODS
A prospective cohort study included 134 adult patients with VL admitted to the University Hospital of the Federal University of Mato Grosso do Sul between August 2011 and August 2013.


RESULTS
Patients ranged from 18 to 93 years old, with a mean age of 43.6 (±15.7%). Of these patients, 36.6% were co-infected with HIV/AIDS, and the mortality rate was 21.6%. In a multivariate analysis, the risk factors associated with death were secondary bacterial infection (42.86, 5.05-363.85), relapse (12.17, 2.06-71.99), edema (7.74, 1.33-45.05) and HIV/AIDS co-infection (7.33, 1.22-43.98).


CONCLUSIONS
VL has a high mortality rate in adults from endemic urban areas, especially when coinciding with high rates of HIV/AIDS co-infection.
University Hospital, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil; Post Graduation Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Angelita F
AF
Druzian
Center for Biological and Health Sciences, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Albert S
AS
de Souza
Medicine Faculty, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Diogo N
DN
de Campos
Oswaldo Cruz Foundation-Fiocruz, Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil; Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil.
Julio
J
Croda
Post Graduation Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Minoru G
MG
Higa
Post Graduation Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil; Center for Biological and Health Sciences, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Maria Elizabeth C
ME
Dorval
Medicine Faculty, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Mauricio A
MA
Pompilio
Medicine Faculty, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Polliana A
PA
de Oliveira
Post Graduation Program in Infectious and Parasitic Diseases, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil; Medicine Faculty, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.
Anamaria M M
AM
Paniago
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014505:Urban Population; D055815:Young Adult