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

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art_MAIA-ELKHOURY_Premature_deaths_by_visceral_leishmaniasis_in_Brazil_investigated_2019.PDF.pdf (1.62 MB)
Citações na Scopus
7
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
PUBLIC LIBRARY SCIENCE
Autores
MAIA-ELKHOURY, Ana Nilce S.
ROMERO, Gustavo Adolfo Sierra
VALADAS, Samantha Y. O. B.
SOUSA-GOMES, Marcia L.
CUPOLILLO, Elisa
RUIZ-POSTIGO, Jose Antonio
ARGAW, Daniel
SANCHEZ-VAZQUEZ, Manuel J.
Citação
PLOS NEGLECTED TROPICAL DISEASES, v.13, n.12, article ID e0007841, 18p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background 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.
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URI
https://observatorio.fm.usp.br/handle/OPI/37769
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - LIM/49
Artigos e Materiais de Revistas Científicas - ODS/03