Factors of poor prognosis of visceral leishmaniasis among children under 12 years of age: A retrospective monocentric study in Belo Horizonte, State of Minas Gerais, Brazil, 2001-2005
Rev. Soc. Bras. Med. Trop
;
46(1): 55-59, Jan.-Feb. 2013. tab
Article
in English
| LILACS
| ID: lil-666795
ABSTRACT
INTRODUTION A major concern with the visceral leishmaniasis (VL) is its high lethality rate, even with proper treatment. Low age, prior malnutrition, disease duration prior to diagnosis, severe anemia, fever for more than 60 days, diarrhea and jaundice are known poor prognostic factors. The goals of this study are to describe the clinical and laboratory characteristics of VL among children under 12 years of age and to identify the factors associated with VL poor outcome. METHODS:
Two hundred and fifty children under 12 years of age with confirmed VL admitted to Hospital João Paulo II (FHEMIG), Belo Horizonte, Brazil, between January 2001 and December 2005 were evaluated retrospectively. The primary outcome was the poor clinical evolution sepsis, and/or pneumonia, and/or urinary tract infection, and/or of bleeding (expect epistaxis), and/or severe neutropenia (neutrophil < 500 cells/mm³). Odds ratio (crude and adjusted) and its 95% confidence interval for each variable were calculated. Values less than 0.05 were considered significant.RESULTS:
Average age was 3.3 years (3.6 months-11.6 years), 71.2% were younger than 5 years and 47.2% lived in Metropolitan Area of Belo Horizonte. The mean fatality rate was 3.6%. Sixty-six (26.4%) patients presented poor evolution. After a multivariate analysis, age <18 months, abnormal respiratory physical examination on hospital admission, and platelets <85,000/mm³ remained associated with increased chance of poor evolution.CONCLUSIONS:
The results suggest that patients aged between 12 and 18 months, with platelet counts bellow 85,000/mm³, and respiratory abnormalities at admission should be considered potentially severe.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Hospitalization
/
Leishmaniasis, Visceral
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
Rev. Soc. Bras. Med. Trop
Journal subject:
Tropical Medicine
Year:
2013
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Fundação Hospitalar do Estado de Minas Gerais/BR
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