Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda
Risk factors for in-hospital mortality of visceral leishmaniasis patients in eastern Uganda
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DOI：
10.1111/j.1365-3156.2009.02305.x
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发表时间：
2009-08-01
影响因子：
3.3
通讯作者：
Chappuis, Francois
中科院分区：
文献类型：
--
作者：
Mueller, Yolanda;Mbulamberi, Dawson B.;Chappuis, Francois
目的探讨乌干达内脏利什曼病(VL)患者住院期间死亡的危险因素。方法回顾分析乌干达东部阿穆达特无国界医生组织(Medecins Sans Frontieres)监测内脏利什曼病(VL)患者的临床资料。结果2000年至2005年，在3483名临床疑似患者中，53%确诊为原发VL。62%是16岁的儿童，男女比例为2.2。使用五价锑(n=1641)或常规两性霉素B(n=217)治疗的总病死率为3.7%。两个治疗组之间的病死率没有差异(P>；0.20)。通过多因素分析确定住院死亡的主要危险因素是6岁和15岁，合并肺结核或肝病，以及与药物相关的不良事件。45岁患者的病死率非常高(29.0%)。结论乌干达现有药物治疗期间死亡风险较高的VL患者亚群。这些患者应该评估和使用毒性较小的药物。
OBJECTIVE To identify risk factors for in-hospital mortality in patients treated for visceral leishmaniasis (VL) in Uganda.METHODS Retrospective analysis of VL patients' clinical data collected for project monitoring by Medecins Sans Frontieres in Amudat, eastern Uganda. results Between 2000 and 2005, of 3483 clinically suspect patients, 53% were confirmed with primary VL. Sixty-two per cent were children 16 years of age with a male/female ratio of 2.2. The overall case-fatality rate during pentavalent antimonial (n = 1641) or conventional amphotericin B treatment (n = 217) was 3.7%. There was no difference in the case-fatality rate between treatment groups (P > 0.20). The main risk factors for in-hospital death identified by a multivariate analysis were age 6 years and > 15 years, concomitant tuberculosis or hepatopathy, and drug-related adverse events. The case-fatality rate among patients > 45 years of age was strikingly high (29.0%).CONCLUSION Subgroups of VL patients at higher risk of death during treatment with drugs currently available in Uganda were identified. Less toxic drugs should be evaluated and used in these patients.