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
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 go...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sociedade Brasileira de Medicina Tropical (SBMT)
2013-01-01
|
| Series: | Revista da Sociedade Brasileira de Medicina Tropical |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100055&lng=en&tlng=en |
| _version_ | 1818554154932502528 |
|---|---|
| author | Alexandre Sérgio da Costa Braga Antonio Carlos de Castro Toledo Junior Ana Rabello |
| author_facet | Alexandre Sérgio da Costa Braga Antonio Carlos de Castro Toledo Junior Ana Rabello |
| author_sort | Alexandre Sérgio da Costa Braga |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-12T09:35:38Z |
| format | Article |
| id | doaj.art-06e2ea97c7fb452ab8ad3cb9505f7d28 |
| institution | Directory Open Access Journal |
| issn | 1678-9849 |
| language | English |
| last_indexed | 2024-12-12T09:35:38Z |
| publishDate | 2013-01-01 |
| publisher | Sociedade Brasileira de Medicina Tropical (SBMT) |
| record_format | Article |
| series | Revista da Sociedade Brasileira de Medicina Tropical |
| spelling | doaj.art-06e2ea97c7fb452ab8ad3cb9505f7d282022-12-22T00:28:44ZengSociedade Brasileira de Medicina Tropical (SBMT)Revista da Sociedade Brasileira de Medicina Tropical1678-98492013-01-01461555910.1590/0037-868216432013S0037-86822013000100055Factors 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, 2001-2005Alexandre Sérgio da Costa BragaAntonio Carlos de Castro Toledo JuniorAna RabelloINTRODUTION: 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100055&lng=en&tlng=enVisceral leishmaniasisChildrenPrognosis |
| spellingShingle | Alexandre Sérgio da Costa Braga Antonio Carlos de Castro Toledo Junior Ana Rabello 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 Revista da Sociedade Brasileira de Medicina Tropical Visceral leishmaniasis Children Prognosis |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Visceral leishmaniasis Children Prognosis |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822013000100055&lng=en&tlng=en |
| work_keys_str_mv | AT alexandresergiodacostabraga factorsofpoorprognosisofvisceralleishmaniasisamongchildrenunder12yearsofagearetrospectivemonocentricstudyinbelohorizontestateofminasgeraisbrazil20012005 AT antoniocarlosdecastrotoledojunior factorsofpoorprognosisofvisceralleishmaniasisamongchildrenunder12yearsofagearetrospectivemonocentricstudyinbelohorizontestateofminasgeraisbrazil20012005 AT anarabello factorsofpoorprognosisofvisceralleishmaniasisamongchildrenunder12yearsofagearetrospectivemonocentricstudyinbelohorizontestateofminasgeraisbrazil20012005 |