Abstract
OBJECTIVESPoor 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.METHODSA 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, and p-values <0.05 were considered to indicate statistical significance.RESULTSThe 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.CONCLUSIONSPoor 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.
Highlights
Visceral leishmaniasis (VL) is the most severe vector-borne pro tozoan disease caused by Leishmania donovani, and is transmitted by the bite of female Phlebotomus sand flies [1,2]
Copious data on treatment outcomes and their determinants among VL patients are necessary for national control, prevention, and elimination of VL
In comparison with other similar studies conducted elsewhere in Ethiopia (18.5%) [15], poor VL treatment outcomes were found to be common (23.7%) in the current study, which was conducted in northwest Ethiopia
Summary
Visceral leishmaniasis (VL) is the most severe vector-borne pro tozoan disease caused by Leishmania donovani, and is transmitted by the bite of female Phlebotomus sand flies [1,2]. 2017, Korean Society of Epidemiology health problem, imposing an estimated disease burden of 1.98 million disability-adjusted life years and 20,000 to 40,000 deaths per annum around the world [1]. Ninety percent of the global burden of VL occurs in India, Bangladesh, Brazil, Sudan, South Sudan, and Ethiopia [3,4,5]. VL is treatable, in sub-Saharan Africa, mortality associated with VL is still high. This is directly or indirectly related to poor treatment outcomes, which occur for a number of reasons [6,7]. Ethiopia is a country highly affected by VL, with 1,860 cases of VL reported annually and an estimated annual incidence of VL ranging from 3,700 to 7,400 cases [8]
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