Epidemiol Health.  2017;39:e2017001. 10.4178/epih.e2017001.

Visceral leishmaniasis treatment outcome and its determinants in northwest Ethiopia

• Welay GM
• Alene KA
• Dachew BA

• KMID: 2406605
• DOI: http://doi.org/10.4178/epih.e2017001

Abstract

OBJECTIVES
Poor 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.
METHODS
A 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.
RESULTS
The 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.
CONCLUSIONS
Poor 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.

Keyword

Visceral leishmaniasis; Treatment outcome; Determinants; Ethiopia

MeSH Terms

Coinfection
Delayed Diagnosis
Early Diagnosis
Ethiopia*
HIV
Humans
Leishmaniasis, Visceral*
Logistic Models
Mortality
Odds Ratio
Retrospective Studies
Treatment Failure
Treatment Outcome*