Abstract:
Introduction: Leishmaniasis has been associated with poverty and also believed to
constitute a serious impediment to socioeconomic development. The disease is
endemic in the environment that ranges from deserts to rain forests in rural and
urban settings in over 98 countries of the tropics, sub tropics, and southern Europe.
Objectives: To assess visceral leishmaniasis relapse rate among all visceral
leishmaniasis patients in leishmaniasis treatment center at West Armachio,
Northwest Ethiopia, 2014.
Methods: A five years institution based retrospective follow up study was
conducted among 1510 VL patients who were enrolled in Leishmaniasis treatment
center from January, 2009 to December 31, 2013. The information extracted on the
patient records. The data transfers from excel to SPSS version 20 for analysis. Life
table was used to estimate the cumulative VL relapse survival and Log rank tests to
compare relapse survival probability curves between the different categories of the
explanatory variables. Bivariate and multivariate Cox proportional hazards model
were used to identify predictors.
Result: A total of 1676 charts reviewed, out of this 1510 patient records were
included in the analysis. The median age of the study participant was 24 yrs. And a
total of 235 VL relapse cases were observed during the follow up period. Hence, the
overall incidence density of VL relapse was 10 per 10,000 Person months.
Those who were hemoglobin level >7mg/dl had late probability to develop
leishmaniasis relapse than Hgb level less than 7 mg/dl with an (AHR 0.69, 95% CI
0.49, 0.97).and Patients who were taking Ambisone and Ambisone +Meltifocin had
less likely to develop relapse than a patient taking SSG. (AHR 2.62 CI 95% 1.72,
3.97) and AHR3.92 CI 95%2.51, 6.12) respectively.
Discussion: the predictors that were significantly associated with increased risk of
relapse were HIV/AIDS Sero status, advanced WHO clinical stage and, VL
treatment, Discharge hemoglobin level and edema. All this predictors had already
been identified in other studies.
Conclusion and Recommendation: Leishmaniasis prevention strategies need
to be strengthened with early diagnosis and treatment as a recommended in national
guideline.
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