American visceral leishmaniasis: Factors associated with lethality in the state of São Paulo, Brazil

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dc.contributor.authorMadalosso, Geraldine
dc.contributor.authorFortaleza, Carlos Magno Castelo Branco [UNESP]
dc.contributor.authorRibeiro, Ana Freitas
dc.contributor.authorCruz, Lisete Lage
dc.contributor.authorNogueira, Péricles Alves
dc.contributor.authorLindoso, José Angelo Lauletta
dc.contributor.institutionSES
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionUniversidade de São Paulo (USP)
dc.date.accessioned2014-05-27T11:27:06Z
dc.date.available2014-05-27T11:27:06Z
dc.date.issued2012-10-17
dc.description.abstractObjectives. To identify factors associated with death in visceral leishmaniasis (VL) cases. Patients and Methodology. We evaluated prognostic factors for death from VL in São Paulo state, Brazil, from 1999 to 2005. A prognostic study nested in a clinical cohort was carried out by data analysis of 376 medical files. A comparison between VL fatal cases and survivors was performed for clinical, laboratory, and biological features. Association between variables and death was assessed by univariate analysis, and the multiple logistic regression model was used to determine adjusted odds ratio for death, controlling confounding factors. Results. Data analysis identified 53 fatal cases out of 376 patients, between 1999 and 2005 in São Paulo state. Lethality was 14.1 (53/376), being higher in patients older than fifty years. The main causes of death were sepsis, bleeding, liver failure, and cardiotoxicity due to treatment. Variables significantly associated with death were severe anemia, bleeding, heart failure, jaundice, diarrhea, fever for more than sixty days, age older than fifty years, and antibiotic use. Conclusion. Educational health measures are needed for the general population and continuing education programs for health professionals working in the affected areas with the purpose of identifying and treating early cases, thus preventing the disease evolution towards death. © 2012 Geraldine Madalosso et al.en
dc.description.affiliationCentro de Vigilância Epidemiológica Prof. Alexandre Vranjac Coordenadoria de Controle de Doenças SES, 01246-902, São Paulo, SP
dc.description.affiliationDepartamento de Doenças Tropicais e Diagnóstico Por Imagem Universidade Estadual Paulista Júlio de Mesquita Filho, 18618-970 Botucatu, SP
dc.description.affiliationDepartamento de Epidemiologia Faculdade de Saúde Pública Universidade de São Paulo, 01246-904 São Paulo, SP
dc.description.affiliationInstituto de Infectologia Emílio Ribas SES, 01246-900 São Paulo SP
dc.description.affiliationLaboratório de Soroepidemiologia (LIM 38 HC-FMUSP) Instituto de Medicina Tropical Universidade de São Paulo, 05403-000 São Paulo, SP
dc.description.affiliationUnespDepartamento de Doenças Tropicais e Diagnóstico Por Imagem Universidade Estadual Paulista Júlio de Mesquita Filho, 18618-970 Botucatu, SP
dc.identifierhttp://dx.doi.org/10.1155/2012/281572
dc.identifier.citationJournal of Tropical Medicine.
dc.identifier.doi10.1155/2012/281572
dc.identifier.file2-s2.0-84867370121.pdf
dc.identifier.issn1687-9686
dc.identifier.issn1687-9694
dc.identifier.scopus2-s2.0-84867370121
dc.identifier.urihttp://hdl.handle.net/11449/73669
dc.language.isoeng
dc.relation.ispartofJournal of Tropical Medicine
dc.relation.ispartofsjr0,508
dc.relation.ispartofsjr0,508
dc.rights.accessRightsAcesso aberto
dc.sourceScopus
dc.subjectantibiotic agent
dc.subjectantiprotozoal agent
dc.subjectaspartate aminotransferase
dc.subjectbilirubin
dc.subjectblood derivative
dc.subjectimmunosuppressive agent
dc.subjectadolescent
dc.subjectadult
dc.subjectage
dc.subjectanemia
dc.subjectantibiotic therapy
dc.subjectaspartate aminotransferase blood level
dc.subjectasthenia
dc.subjectbilirubin blood level
dc.subjectbleeding
dc.subjectBrazil
dc.subjectcardiotoxicity
dc.subjectchild
dc.subjectclinical feature
dc.subjectcohort analysis
dc.subjectconfounding variable
dc.subjectcongestive heart failure
dc.subjectcontrolled study
dc.subjectcoughing
dc.subjectdata analysis
dc.subjectdeath
dc.subjectdehydration
dc.subjectdiabetes mellitus
dc.subjectdiarrhea
dc.subjectdrowsiness
dc.subjectdrug fatality
dc.subjectdyspnea
dc.subjectedema
dc.subjectfatality
dc.subjectfebrile neutropenia
dc.subjectfever
dc.subjectheart arrhythmia
dc.subjectheart failure
dc.subjecthuman
dc.subjecthypoalbuminemia
dc.subjectinfant
dc.subjectjaundice
dc.subjectlaboratory test
dc.subjectlethality
dc.subjectliver disease
dc.subjectliver failure
dc.subjectmajor clinical study
dc.subjectmedical record
dc.subjectmultivariate logistic regression analysis
dc.subjectopportunistic infection
dc.subjectpallor
dc.subjectperipheral vascular disease
dc.subjectpneumonia
dc.subjectpreschool child
dc.subjectpriority journal
dc.subjectprognosis
dc.subjectrisk
dc.subjectrisk factor
dc.subjectschool child
dc.subjectsepsis
dc.subjectsplenectomy
dc.subjectsurvivor
dc.subjectthrombocytopenia
dc.subjecttuberculosis
dc.subjectunivariate analysis
dc.subjectvisceral leishmaniasis
dc.subjectvomiting
dc.titleAmerican visceral leishmaniasis: Factors associated with lethality in the state of São Paulo, Brazilen
dc.typeArtigo
dcterms.licensehttp://www.hindawi.com/journals/aaa/guidelines/
unesp.author.lattes2589937673452910[2]
unesp.author.orcid0000-0003-4120-1258[2]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

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