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Risk factors for relapse of visceral leishmaniasis in Georgia

Maia Kajaia1, Dale L Morse, George Kamkamidze

  • 1Maternal and Child Care Union, Tbilisi, Georgia. maiakajaia@yahoo.com

Tropical Medicine & International Health : TM & IH
|December 15, 2010
PubMed

Insights

Identifying prognostic factors for visceral leishmaniasis (VL) relapse is crucial. Delays in diagnosis, low hemoglobin, and young age significantly increase VL relapse risk.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Visceral leishmaniasis (VL) relapses are increasing, necessitating identification of prognostic factors.
  • Early diagnosis and appropriate treatment are vital for managing VL patients.

Purpose of the Study:

  • To identify demographic and clinical factors associated with visceral leishmaniasis relapse.
  • To inform treatment decisions and improve patient outcomes.

Main Methods:

  • Retrospective analysis of medical records from 300 VL patients treated in Georgia (2002-2004).
  • Data abstracted included demographics, diagnosis delays, and treatment regimens.
  • Statistical analysis to determine factors associated with relapse.

Main Results:

  • Factors significantly associated with VL relapse included diagnosis delay >90 days (RR=4.21), hemoglobin <60 g/l (RR=11.96), and age <1 year (RR=2.36).
  • Most patients were children under 5, and 44% experienced diagnostic delays exceeding 30 days.
  • Standard therapy involved pentavalent antimony for 20-25 days.

Conclusions:

  • Delayed diagnosis, severe anemia, and very young age are key predictors of VL relapse.
  • Public and physician education is essential to shorten diagnostic delays.
  • Consideration of longer treatment durations (30 days) or alternative regimens may reduce VL relapses.

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