Prognostic factors for death from visceral leishmaniasis in patients treated with liposomal amphotericin B in an endemic state in Brazil

Tourinho, Bruna Dias; Amâncio, Frederico Figueiredo; Ferraz, Marcela Lencine; Carneiro, Mariângela

doi:10.1093/trstmh/trx029

Cited by 9 publications

(12 citation statements)

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“…The study by Dias‐Tourinho et al . (2017) using a historical cohort of patients reported to SINAN in the State of Minas Gerais from 2008 to 2012 also revealed high lethality rate in patients treated with LAMB . In addition, there are no data available in official information systems and in the literature to establish the epidemiological parameter ‘number of deaths by VL per type of treatment’ for each strategy, since the combination LAMB plus MA is not an option currently available at SUS.…”

Section: Discussionmentioning

confidence: 99%

Treatment for human visceral leishmaniasis: a cost‐effectiveness analysis for Brazil

Carvalho

Peixoto

Romero

et al. 2019

Tropical Med Int Health

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Objective To estimate the cost‐effectiveness of strategies for the treatment of VL in Brazil. Methods Cost‐effectiveness study comparing three therapeutic options: meglumine antimoniate (MA), liposomal amphotericin B (LAMB) and a combination of LAMB plus MA (LAMB plus MA), from public health system and societal perspectives. An analytical decision‐making model was used to compare strategies for the following outcomes: early therapeutic failure avoided at 30 days, days of hospitalisation avoided and VL cure at 180 days. The efficacy and safety parameters of the drugs came from a randomised, open‐label trial and the cost data came from a cost‐of‐illness study, both carried out in Brazil. Results For all outcomes analysed, the LAMB strategy was more effective. The MA strategy was inferior to the LAMB plus MA strategy for the outcomes early therapeutic failure avoided and cure. When only LAMB and MA were compared from a societal perspective, a cost of US$ 278.56 was estimated for each additional early therapeutic failure avoided, a cost of US$ 26.88 for each additional day of hospitalisation avoided and a cost of US$ 89.88 for each additional case of cured VL, for the LAMB strategy vs. MA. Conclusion In Brazil, the LAMB strategy proved to be cost‐effective for treating VL, considering a GDP per capita as the willingness‐to‐pay threshold, for all of the outcomes analysed in comparison to MA.

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Section: Discussionmentioning

confidence: 99%

Treatment for human visceral leishmaniasis: a cost‐effectiveness analysis for Brazil

Carvalho

Peixoto

Romero

et al. 2019

Tropical Med Int Health

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“…Indeed, YLL has increased 108% between 1990 and 2016. The treatment for VL provided by the Brazilian Public Health System consists of three drug options: pentavalent antimonial (which is considered the first choice), amphotericin B deoxycholate, and liposomal amphotericin B [ 29 , 30 ]. The medication must be taken following medical advice due to its toxicity and common adverse events [ 29 , 30 , 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…The treatment for VL provided by the Brazilian Public Health System consists of three drug options: pentavalent antimonial (which is considered the first choice), amphotericin B deoxycholate, and liposomal amphotericin B [ 29 , 30 ]. The medication must be taken following medical advice due to its toxicity and common adverse events [ 29 , 30 , 31 , 32 , 33 ]. Although more specific guidelines for the management of patients suffering from severe VL have been developed in Brazil [ 30 ], the case fatality rate remains around 8%, which is considered high [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

“…The burdens for VL and CML were higher among males in comparison with females in Brazil. The observed findings may indicate that the risk of infection is often related to occupational and behavioral factors, as job positions predominantly taken by men may propitiate contact with the vector and females are usually more likely to seek health services [ 30 , 44 , 46 ]. The increased number of CML cases is also linked to environmental changes, such as deforestation, construction of dams, new irrigation schemes, urbanization, and migration of people from non-endemic to endemic areas [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, the purpose of the Brazilian VL Surveillance and Control Program (VLSCP) is to reduce the case fatality rate, the degree of morbidity, and the risk of VL transmission. The strategies to achieve these goals include canine serological analysis and euthanasia of infected dogs, vector chemical control, early diagnosis and treatment of human cases, and population awareness [ 30 ]. Nevertheless, despite being currently implemented in endemic areas of Brazil, the control interventions for VL remain unsuccessful, and transmission continues, especially in urban areas [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

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Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study 2016

et al. 2018

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BackgroundThe study presents estimates for the burden of visceral leishmaniasis (VL) and cutaneous and mucocutaneous leishmaniasis (CML) in Brazil and its 27 federated units using data from the Global Burden of Disease Study (GBD) 2016.MethodologyWe report the incidence, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) for leishmaniasis in Brazil from 1990 to 2016. The metrics are presented as age-standardized rates per 100,000 inhabitants with their respective uncertainty intervals (95%UI) and relative percentages of change.Principal findingsThe age-standardized incidence rate of leishmaniasis decreased 48.5% from 1990 (71.0, 95%UI 24.3–150.7) to 2016 (36.5, 95%UI 24.7–50.9), whereas the age-standardized DALY increased 83.6% over the studied period from 12.2 (95%UI 7.9–18.8) to 22.4 (95%UI 13.3–36.2). The age-standardized incidence rate and YLL for VL increased by 52.9% and 108% from 1990 to 2016, respectively. Considering CML, the age-standardized incidence rate and YLD decreased by 51% and 31.8% respectively for the same period. For VL, similar profiles for male and female were observed, with YLL and DALY increasing over time; with males presenting slightly higher values. The highest YLL rates were among "under 1-year old" children, which increased 131.2% from 1990 to 2016. Regarding CML, the highest values of YLD and DALY were verified among males, and YLD values showed a similar profile, with rates increasing with age. The VL burden increased in some states in the Northeast and Southeast regions and decreased for CML in some Northern states.ConclusionThe increase of VL burden over the study period might be associated with the difficulties in controlling the disease spread. Information regarding the weight of VL and CML, including the death and disability tolls that they cause, highlights the impact of these neglected diseases on public health and the importance of effective prevention and treatment.

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Risk factors for in-hospital mortality from visceral leishmaniasis: A case-control study

Oliveira-Sena

Werneck

2020

Journal of Infection and Public Health

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Prognostic factors for death from visceral leishmaniasis in patients treated with liposomal amphotericin B in an endemic state in Brazil

Cited by 9 publications

References 20 publications

Treatment for human visceral leishmaniasis: a cost‐effectiveness analysis for Brazil

Treatment for human visceral leishmaniasis: a cost‐effectiveness analysis for Brazil

Burden of leishmaniasis in Brazil and federated units, 1990-2016: Findings from Global Burden of Disease Study 2016

Risk factors for in-hospital mortality from visceral leishmaniasis: A case-control study

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