American Visceral Leishmaniasis: Factors Associated with Lethality in the State of São Paulo, Brazil

Abstract

Objectives. To identify factors associated with death in visceral leishmaniasis (VL) cases. Patients and Methodology. We evaluated prognostic factors for death from VL in São Paulo state, Brazil, from 1999 to 2005. A prognostic study nested in a clinical cohort was carried out by data analysis of 376 medical files. A comparison between VL fatal cases and survivors was performed for clinical, laboratory, and biological features. Association between variables and death was assessed by univariate analysis, and the multiple logistic regression model was used to determine adjusted odds ratio for death, controlling confounding factors. Results. Data analysis identified 53 fatal cases out of 376 patients, between 1999 and 2005 in São Paulo state. Lethality was 14.1% (53/376), being higher in patients older than fifty years. The main causes of death were sepsis, bleeding, liver failure, and cardiotoxicity due to treatment. Variables significantly associated with death were severe anemia, bleeding, heart failure, jaundice, diarrhea, fever for more than sixty days, age older than fifty years, and antibiotic use. Conclusion. Educational health measures are needed for the general population and continuing education programs for health professionals working in the affected areas with the purpose of identifying and treating early cases, thus preventing the disease evolution towards death.

Epidemiological aspects of human and canine visceral leishmaniasis in State of Alagoas, Northeast, Brazil

“…Articles de Araújo et al (2012), Góes et al (2012) and Madalosso et al (2012), fatality rates were raised by LV, with 24.4% variation to 69% between people aged ≥ 60 years, but that contrasts with the poverty of the literature on clinical information during this period of life of imunosenescência of LV.…”

Spatial and spatiotemporal occurrence of human visceral leishmaniasis in Adamantina, State of São Paulo, Brazil

“…These results differ from those of other studies (16) (18) (19) , wherein the ≥60 age group demonstrated the highest mortality and fatality rates. Mortality rates would presumably be higher in this age group owing to a combination of HLV with other diseases already acquired, leading to adverse reactions caused by medicines (18) (19) . The high mortality rate and fatality rates in the 0-4-year-old age group in Adamantina could be a consequence of the highest incidence rate being observed in this group.…”

Temporal, spatial and spatiotemporal analysis of the occurrence of visceral leishmaniasis in humans in the City of Birigui, State of São Paulo, from 1999 to 2012

“…In Brazil, VL is present in 26 states of the fi ve regions of the Brazilian territory [2][3][4][5] . Since 1980, there has been a change in the epidemiological pattern of VL, which was previously characterized as a rural disease.…”