Treatment outcome of visceral leishmaniasis and associated factor in pediatrics ward University of Gondar Compressive Specialized Hospital, Northwest Ethiopia.

Abstract

Abstract Background: Visceral leishmaniasis is found in all continents except Antarctica. Younger age is highly affected by visceral leishmaniasis. And age <15 years and cover 65% of visceral leishmaniasis in east Africa.There is a paucity of data on factors associated with treatment outcome in younger age children. Objective: The aim of this study was to assess the treatment outcome and associated factors of visceral leishmaniasis in pediatric patient at University of Gondar Compressive Specialized Hospital Ethiopia. Methods: Institutional based cross sectional study was conducted on pediatrics VL patients who were admitted to pediatric ward in University of Gondar Compressive Specialized Hospital Northwest Ethiopia from June to August 2019. All admitted pediatric VL pediatrics were included in this study. Patient information was collected by reviewing medical records of the patient. Data was collected by a preliminarily reviewed abstraction format then entered into EpiInfo version 7.0 and exported to SPSS version 20 for analysis & Bivariable and Multivariable logistic regression was used. Odds ratio with 95% confidence interval were used, and p-values < 0.05 were considered to be statistically significant. Result: The most prevalent treatment outcome in pediatric ward was clinical cure which account (77.5%) [95%CI: 71,83],followed by partial response, death, and relapse (15%)[95%CI:10,20], (5%)[95%CI:2,8],(2.5%)[95%CI:0.5,5] respectively. The associated factors for treatment outcome related to cure are age <5 year was decreased outcome of cure by 80% compared to pediatric 11-15 year (AOR 0.2: 95% CI 0.004-0.6).Pediatrics in rural was 4 times cure than pediatrics in urban (AOR 4: 95% CI 2-11).Pediatrics who were getting hospitalization for 11-20 days 4 times cure compared to pediatrics hospitalization >21 days (AOR 4: 95% CI 116).Immunocompetent pediatrics was 3 times cure compared to pediatrics who were Immunocompromised(AOR 3: 95% CI 1-9).Pediatrics who were treated by international guideline were 26 times higher than cured pediatrics who were treated by local guideline (AOR 26, 95% CI 8-82). Conclusion: The proportion of clinical cure was found to be high. Age, residence, immunocompetent, hospitalization, and adherence of international guideline were found to be independent predictors of treatment outcome. Experimental studies should be conducted to subside the poor treatment outcome. Keyword: Treatment outcome, visceral Leishmania, pediatrics, Gondar Ethiopia.