Premature deaths by visceral leishmaniasis in Brazil investigated through a cohort study: A challenging opportunity?

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMAIA-ELKHOURY, Ana Nilce S.
dc.contributor.authorROMERO, Gustavo Adolfo Sierra
dc.contributor.authorVALADAS, Samantha Y. O. B.
dc.contributor.authorSOUSA-GOMES, Marcia L.
dc.contributor.authorLINDOSO, Jose Angelo Lauletta
dc.contributor.authorCUPOLILLO, Elisa
dc.contributor.authorRUIZ-POSTIGO, Jose Antonio
dc.contributor.authorARGAW, Daniel
dc.contributor.authorSANCHEZ-VAZQUEZ, Manuel J.
dc.date.accessioned2020-10-15T14:35:40Z
dc.date.available2020-10-15T14:35:40Z
dc.date.issued2019
dc.description.abstractBackground Visceral Leishmaniasis (VL) is the most severe form of leishmaniasis because it can lead to death. In the Americas, 96% of cases are in Brazil, and despite efforts, the fatality rate has increased in the past years. We analyzed deaths associated to VL in Brazil and investigated the factors that could influence on the timeliness of fatal outcome with emphasis on time (tStoD). Methodology The registered deaths by VL were sourced from the Brazilian National Notification System from 2007-2014. Through a retrospective cohort study, univariate and multivariable Cox proportional hazards model analysis were performed and investigated the factors that could influence the time (tStoD). These factors were analyzed through survival models. Results Out of the 1,589 reported deaths, the median for onset of the symptoms and the case notification date (tStoN) is 25 days (10-61), and for date of case notification and death (tNotD) is 9 days (4-17). The time (tStoN) to event investigation for HIV non-infected individuals was 1.4 (1.16-1.68) greater than the HIV positive group. At the same time peri-urban and urban area were 0.83 (0.47-1.44) and 1.33 (1.16-1.52), respectively. The explorations revealed apparent differences between the time to event investigation (both for tStoN and tNotD) and the age at the onset of the symptoms. According to the tStoN the rate of notification is 1.73 times greater in patients under 5 years old at the onset of the clinical symptoms compared to older patients. Conclusion VL patients under 5 years old were diagnosed earlier and had shorter survival. It could mean that in younger population, although properly diagnosed, the fatality pattern might be related to the severity of the disease. Main host characteristics were evaluated, and age and co-infections seem to have an impact in the disease progression.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipWorld Health OrganizationWorld Health Organization [001] Funding Source: Medline
dc.identifier.citationPLOS NEGLECTED TROPICAL DISEASES, v.13, n.12, article ID e0007841, 18p, 2019
dc.identifier.doi10.1371/journal.pntd.0007841
dc.identifier.issn1935-2735
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/37769
dc.language.isoeng
dc.publisherPUBLIC LIBRARY SCIENCEeng
dc.relation.ispartofPlos Neglected Tropical Diseases
dc.rightsopenAccesseng
dc.rights.holderCopyright PUBLIC LIBRARY SCIENCEeng
dc.subject.otherkala-azareng
dc.subject.otheroutcomeseng
dc.subject.othertestseng
dc.subject.wosInfectious Diseaseseng
dc.subject.wosParasitologyeng
dc.subject.wosTropical Medicineeng
dc.titlePremature deaths by visceral leishmaniasis in Brazil investigated through a cohort study: A challenging opportunity?eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countrySuíça
hcfmusp.affiliation.countryisoch
hcfmusp.author.externalMAIA-ELKHOURY, Ana Nilce S.:Pan Amer Hlth Org World Hlth Org PAHO WHO, Neglected Trop & Vector Borne Dis VT, Communicable Dis & Environm Determinants Hlth CDE, Duque De Caxias, RJ, Brazil
hcfmusp.author.externalROMERO, Gustavo Adolfo Sierra:Univ Brasilia, Fac Med, Ctr Trop Med, Brasilia, DF, Brazil
hcfmusp.author.externalVALADAS, Samantha Y. O. B.:Pan Amer Hlth Org World Hlth Org PAHO WHO, Neglected Trop & Vector Borne Dis VT, Communicable Dis & Environm Determinants Hlth CDE, Duque De Caxias, RJ, Brazil
hcfmusp.author.externalSOUSA-GOMES, Marcia L.:Minist Hlth, Secretary Hlth Surveillance, Brasilia, DF, Brazil
hcfmusp.author.externalCUPOLILLO, Elisa:Fiocruz MS, Oswaldo Cruz Fdn, Inst Oswaldo Cruz IOC, Rio De Janeiro, Brazil
hcfmusp.author.externalRUIZ-POSTIGO, Jose Antonio:World Hlth Org WHO, Dept Neglected Trop Dis HTM NTD IDM, Geneva, Switzerland
hcfmusp.author.externalARGAW, Daniel:World Hlth Org WHO, Dept Neglected Trop Dis HTM NTD IDM, Geneva, Switzerland
hcfmusp.author.externalSANCHEZ-VAZQUEZ, Manuel J.:Pan Amer Foot & Mouth Dis Ctr PANAFTOSA PAHO, Duque De Caxias, RJ, Brazil
hcfmusp.citation.scopus7
hcfmusp.contributor.author-fmusphcJOSE ANGELO LAULETTA LINDOSO
hcfmusp.description.articlenumbere0007841
hcfmusp.description.issue12
hcfmusp.description.volume13
hcfmusp.origemWOS
hcfmusp.origem.pubmed31856199
hcfmusp.origem.scopus2-s2.0-85077086830
hcfmusp.origem.wosWOS:000559317800019
hcfmusp.publisher.citySAN FRANCISCOeng
hcfmusp.publisher.countryUSAeng
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