title: Visceral leishmaniasis treatment outcome and its determinants in northwest Ethiopia.
abstract: OBJECTIVE
  Poor treatment outcomes of visceral leishmaniasis (VL) are responsible for the high mortality rate of this condition in resource-limited settings such as Ethiopia. This study aimed to identify the proportion of poor VL treatment outcomes in northwest Ethiopia and to evaluate the determinants associated with poor outcomes.
  
  
  METHODS
  A hospital-based retrospective study was conducted among 595 VL patients who were admitted to Kahsay Abera Hospital in northwest Ethiopia from October 2010 to April 2013. Data were entered into Epi Info version 7.0 and exported to SPSS version 20 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of VL treatment outcomes. Adjusted odds ratio (aORs) with 95% confidence intervals (CIs) were used, andp-values <0.05 were considered to indicate statistical significance.
  
  
  RESULTS
  The proportion of poor treatment outcomes was 23.7%. Late diagnosis (≥29 days) (aOR, 4.34; 95% CI, 2.22 to 8.46), severe illness at admission (inability to walk) (aOR, 1.63; 95% CI, 1.06 to 2.40) and coinfection with VL and human immunodeficiency virus (HIV) (aOR, 2.72; 95% CI, 1.40 to 5.20) were found to be determinants of poor VL treatment outcomes.
  
  
  CONCLUSIONS
  Poor treatment outcomes, such as death, treatment failure, and non-adherence, were found to be common. Special attention must be paid to severely ill and VL/HIV-coinfected patients. To improve VL treatment outcomes, the early diagnosis and treatment of VL patients is recommended.
authors.affiliation: Aksum University, Shire Campus, Shire, Ethiopia.
authors.forename: Getachew Mebrahtu
authors.initials: GM
authors.lastname: Welay
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
authors.forename: Kefyalew Addis
authors.initials: KA
authors.lastname: Alene
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.|The University of Queensland, School of Public Health, Herston Qld 4006, Australia.
authors.forename: Berihun Assefa
authors.identifier: 0000-0002-4041-6129
authors.initials: BA
authors.lastname: Dachew
mesh_terms: D000293:Adolescent; D060085:Coinfection; D057210:Delayed Diagnosis; D005002:Ethiopia; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006761:Hospitals; D006801:Humans; D007893:Leishmania donovani; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000401:mortality / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010349:Patient Compliance; D011787:Quality of Health Care; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017211:Treatment Failure; D016896:Treatment Outcome
keywords: Determinants; Ethiopia; Treatment outcome; Visceral leishmaniasis