Risk Factors of Inpatients Mortality of Visceral Leishmaniasis, Khartoum State, Sudan.

ABSTRACT

BACKGROUND: Visceral leishmaniasis (VL) is one of the common infections in Sudan and can be associated with an increase in morbidity and mortality. The aim of this study was to assess the risk factors associated with mortality and morbidity with VL. MATERIALS AND METHODS: This is a cross-sectional hospital-based study that recruited 150 patients with VL from two centers in Khartoum. Secondary data were extracted from the patient records, and data were analyzed using SPSS version 24.0. RESULTS: The study included 2.5% of infants, 39.4% children, and 58% of adults. Male represents 77.3% of the cohort, and total mortality was 16%. Among the death reported 12.5% in infants, 16.7% were children, and 70.8% were in adults. Laboratory parameters significantly associated with mortality in univariate analysis were low white cell count, low platelets, high creatinine, and high liver enzymes. While risk factors such as infant, male, acquired infection from Eastern Sudan or White Nile, weight loss, morbid diseases, and concomitant bacterial infections were also associated with significant mortality in univariate analysis. Importantly, logistic regression analysis revealed significant association with infant (P = 0.02), concomitant bacterial infections (P = 0.003), comorbid disease (P = 0.001), low total blood cell count (P = 0.018), low platelets (P = 0.013), and high aspartate transaminase/alanine aminotransferase (P = 0.013). CONCLUSION: Health education and awareness are needed in terms of prevention and control, especially with high mortality seen in the infant. Treatment of underlying co-morbid diseases and bacterial infections are important to enhance survival. Patients with Leishmania are vulnerable; therefore, regular routine blood tests are an essential part of management to manage complications such as renal, hepatic failure, or severe anemia.