Treatment Outcomes of Patients With Visceral Leishmaniasis in Konso Zone, Southern, Ethiopia
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Date
2023-10
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Addis Ababa University
Abstract
Background: Visceral leishmaniasis is one of the most neglected tropical diseases caused by
protozoa of the genus Leishmania. Leishmaniasis is estimated to affect 0.7–1 million people,
with 350 million people at risk, globally. It is characterized by a broad range of clinical and
laboratory findings like fever, cachexia, hepatosplenomegaly, pancytopenia, hypo albuminuria,
anemia, leucopenia, polyclonal hyper gamma globulinemia, or lymph node enlargement. So
diagnosis and treatment of visceral leishmaniasis is difficult and without appropriate treatment,
an estimated 95 % of VL patients will die.
Objective: This study aimed to analyze treatment outcomes of patients with visceral
leishmaniasis in Konso Zone, Southwest, Ethiopia
Methods: Health facility -based, Cross-sectional, retrospective study was conducted among VL
patients who were treated in Konso zone health facilities. Charts of all patients that have been
treated from 2007 to 2022 in the zone that fulfills the inclusion criteria were reviewed. The data
was entered and cleaned using SPSS 20 statistical packages and analysis was carried out using
the SPSS 20 statistical packages. To identify factors associated with poor treatment outcomes,
bivariate, and multivariable logistic regression were carried out.
Result: A total of 381 patient's charts were reviewed. The overall level of poor treatment
outcomes was 6.6%. The presence of sepsis (AOR=3.323%, 95% CI :(1.191-9.273) P=0.022,
ascites (AOR=5.919%, 95% CI: (2.269-15.444) P< 0.001, lymphadenopathy (AOR=4.879%,
95% CI:(1.875-12.694) P=0.001 and prolonged presentation to health facility of more than one
month during illness (AOR= 0.366%,95% CI: (0.136-0.985) P=0.047 were found to be the
independent predictors of treatment outcomes. Whereas treatment with the combination of SSG
& PM as antileishmanial was inversely related with the poor treatment outcomes (AOR=
0.051%, 95% CI: (0.084-0.774) P=0.016.
Conclusion and recommendation: Sepsis, ascites, lymphadenopathy, and prolonged duration of
illness at presentation were independent predictors of poor treatment outcomes, whereas
treatment with the combination of SSG & PM as antileishmanial was inversely related with the
poor treatment outcomes. Awareness creation in the community on signs and symptoms of VL
and scaling up the health-seeking behavior to enhance early presentation to health facilities and
training of health care providers on complications of VL patients are some of the strategies to be
promoted in improving patient outcomes in VL control programs. Special attention and care
should be given to VL patients with sepsis, ascites, and lymphadenopathy.
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Keywords
Visceral leishmaniasis, treatment outcomes, Southwest Ethiopia.