Predicting death from kala-azar: construction, development, and validation of a score set and accompanying software

Costa, Dorcas Lamounier; Rocha, Regina Lunardi; Chaves, Eldo de Brito Ferreira; Batista, Vivianny Gonçalves de Vasconcelos; Costa, Henrique Lamounier; Costa, Carlos Henrique Nery

doi:10.1590/0037-8682-0258-2016

Cited by 37 publications

(74 citation statements)

References 48 publications

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“…This finding is also similar with those of studies conducted in Gedaref state of Sudan, America and Brazil. 5,[16][17][18][19]24 This could be possibly due to the presence of liver dysfunction among VL patients with jaundice (jaundice is usually the sign of liver dysfunction); therefore, VL patients with jaundice might have decreased plasma protein synthesis, inability to detoxify drugs and impairment of other liver functions compared to VL patients without jaundice.…”

Section: Discussionmentioning

confidence: 99%

“…Toxicity during treatment: the presence of one or more of documented toxicity such as cardiac arrest, pancreatitis, jaundice (liver disease) and kidney failure. 18…”

Section: Operational Definitionsmentioning

confidence: 99%

“…This is because the disease is more prevalent in Kola to Weina Dega agro-ecological zones of Ethiopia, areas where major agricultural projects exist. 12 Predictors of mortality among VL patients include presence of drug toxicity, 13 malnutrition, 3,14,15 VL-HIV co-infection, 5,8,[15][16][17][18][19][20][21][22] thrombocytopenia, 5,10,[16][17][18][19]23 leukopenia, 5,[16][17][18][19]24 jaundice, 5,[16][17][18][19]24 relapsing course of the disease, 10,20,23 high parasite load, [25][26][27] renal failure (creatinine >1.5 mg/dl), 18,24 diarrhea, 9,10,23 nasal bleeding, 5,9,[16]…”

Section: Introductionmentioning

confidence: 99%

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<p>Incidence of Mortality and Its Predictors Among Adult Visceral Leishmaniasis Patients at the University of Gondar Hospital: A Retrospective Cohort Study</p>

Yeshaw¹,

Tsegaye²,

Nigatu³

2020

IDR

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Background: Visceral leishmaniasis (VL) is a neglected tropical disease, affecting the poor and productive age group of a country, resulting in a huge impact on its economic development. Even though anti-leishmanial drugs reduce the incidence of mortality among VL patients, there is still death of these patients while on treatment. In this aspect, there are limited studies in Ethiopia; therefore, this study aimed to determine the incidence of mortality and its predictors among adult VL patients at the University of Gondar Hospital. Methods: Institution-based retrospective cohort study was conducted among 586 adult visceral leishmaniasis patients who were admitted to the University of Gondar Hospital from 2013 to 2018. Data were collected from the patients' charts and registration books, and analyzed using Stata 14 software. Kaplan-Meier failure curve and Log rank test was used to compare the survival probability of patients with independent variables. A multivariable stratified Cox regression model was used to identify predictors of mortality among VL patients. P≤ 0.05 was employed to declare statistically significant factors. Adjusted hazard ratio (AHR) and 95% confidence interval (95% CI) were estimated for potential risk factors included in the multivariable model. Results: A total of 586 VL patients were included in the study. The age of patients ranged from 18 to 55 years with a median age of 27 years. The incidence of mortality was 6.6 (95% CI: 5.2-8.4) per 1000 person-days of observation. Independent predictors of mortality were presence of comorbidity (AHR=2.29 (95% CI: 1.27-4.11)), relapse VL (AHR=3.03 (95% CI: 1.25-7.35)), treatment toxicity (AHR=5.87 (95% CI: 3.30-10.44)), nasal bleeding (AHR=2.58 (95% CI: 1.48-4.51)), jaundice (AHR=2.84 (95% CI: 1.57-5.16)) and being bedridden at admission (AHR=3.26 (95% CI: 1.86-5.73)). Conclusion: The incidence of mortality among VL patients was high. Mortality was higher among VL patients with concomitant disease, relapse VL, treatment toxicity, nasal bleeding, jaundice, and those who were bedridden at admission, which implies that great care should be taken for these risky groups through strict follow-up and treatments.

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Section: Discussionmentioning

confidence: 99%

“…Toxicity during treatment: the presence of one or more of documented toxicity such as cardiac arrest, pancreatitis, jaundice (liver disease) and kidney failure. 18…”

Section: Operational Definitionsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Incidence of Mortality and Its Predictors Among Adult Visceral Leishmaniasis Patients at the University of Gondar Hospital: A Retrospective Cohort Study</p>

Yeshaw¹,

Tsegaye²,

Nigatu³

2020

IDR

View full text Add to dashboard Cite

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“…presence of one or more of documented toxicity such as cardiac arrest, pancreatitis, jaundice (liver disease) and kidney failure [20].…”

Section: Methodsmentioning

confidence: 99%

“…Predictors of mortality among VL patients include: presence of drug toxicity [15], malnutrition [3,16,17], VL-HIV co-infection [5,9,17–24],thrombocytopenia [5,11,18–21,25], leukopenia [5,18–21,26], jaundice [5,18–21,26], relapsing course of the disease [11,22,25], high parasite load [8,27,28], renal failure(creatinine>1.5 mg/dl)[20,26], diarrhea [10,11,25], bleeding [5,10,18–21], anemia [11,17,25], inability to walk at admission [9], longer duration of illness [17], concomitant disease [5,18–21], late diagnosis [6,9,29] and edema [5,18–21].…”

Section: Introductionmentioning

confidence: 99%

Incidence of mortality and its predictors among adult Visceral Leishmaniasis patients at University of Gondar Comprehensive Specialized Hospital, Ethiopia

Yeshaw

Tsegaye

Nigatu

2019

Preprint

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8Background: Visceral leishmaniasis (VL) is a neglected tropical disease resulting in a huge 9 burden of mortality and impact on development of a country. Even though anti-leishmanial 10 drugs reduce the incidence of mortality among VL patients, still there is a death of VL patients 11 while on treatment. However, study on incidence of mortality and its predictors among these 12 patients while on treatment is scarce in Ethiopia. 13Objective: The aim of this study was to determine incidence of mortality and its predictors 14 among adult VL patients at University of Gondar Hospital. 15 Methods: Institution based retrospective follow up study was conducted from 2013 to 2018 at 16 University of Gondar Hospital. Data were collected from patients' chart and analyzed using 17 Stata 14. Kaplan Meier failure curve and Log Rank test was used to compare survival 18 probability of patients with categorical variables. Multivariable stratified Cox model was used 19to identify predictors of mortality among VL patients. P≤ 0.05 was employed to declare 20 statistically significant factors. Adjusted Hazard Ratio (AHR) and its 95% confidence interval 21 (95% CI) was estimated for potential risk factors included in the multivariable model. 22Results: A total of 586 VL patients were included in the study. The median age of patients was 23 23 years. The incidence of mortality was 6.6 (95% CI: 5.2 -8.4) per 1000 person-days of 2 24 observation. Independent predictors of mortality were: presence of comorbidity (AHR=2.29 ( 25 95% CI: 1.27-4.11)), relapse VL (AHR=3.03 (95% CI: 1.25-7.35)), toxicity of treatment drug 26 (AHR=5.87( 95% CI:3.30-10.44)), nasal bleeding (AHR=2.58 ( 95%CI: 1.48-4.51)), jaundice 27 (AHR=2.84 (95% CI: 1.57-5.16)) and being bedridden (AHR=3.26 (95 % CI: 1.86-5.73)). 28Conclusion: The incidence of mortality among VL patients was high. Mortality was higher 29 among VL patients with concomitant disease, relapse, toxicity during treatment, nasal 30 bleeding, jaundice, and bedridden patients. Therefore, strict follow up and treatment of VL 31 patients who have comorbidity, relapse VL, toxicity, nasal bleeding and jaundice were crucial 32 so as to reduce the risk of mortality. 33Visceral leishmaniasis is a neglected tropical disease caused by a protozoa parasite. Over 90% 37 of global burden of VL occurs in poor rural and suburban areas in seven countries including 38 our country, Ethiopia. If not appropriately treated, over 95% of VL cases will eventually die. 39The emergence of VL in Ethiopia places a huge burden on society as it affects poor, young and 40 productive age group of its population. However, there is scarcity of data about incidence of 41 mortality and its predictors among adult VL patients in Ethiopia. 42In this study, a registry of VL patients at Gondar University Hospital was taken to determine 43 the incidence of VL mortality and its predictors. Mortality rate was higher among VL patients 44 with concomitant disease, relapse, drug toxicity, nasal bleeding and jaundice. Therefore, strict 45 follow up a...

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Development of a software for mobile devices designed to help with the management of individuals with neglected tropical diseases

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Predicting death from kala-azar: construction, development, and validation of a score set and accompanying software

Cited by 37 publications

References 48 publications

<p>Incidence of Mortality and Its Predictors Among Adult Visceral Leishmaniasis Patients at the University of Gondar Hospital: A Retrospective Cohort Study</p>

<p>Incidence of Mortality and Its Predictors Among Adult Visceral Leishmaniasis Patients at the University of Gondar Hospital: A Retrospective Cohort Study</p>

Incidence of mortality and its predictors among adult Visceral Leishmaniasis patients at University of Gondar Comprehensive Specialized Hospital, Ethiopia

Development of a software for mobile devices designed to help with the management of individuals with neglected tropical diseases

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