Clinical and Hematological Features and Treatment Outcomes of Visceral Leishmaniasis Patients Admitted To Gondar University Hospital

Abstract

Back ground: Visceral leishmaniasis (VL) is zoonotic or anthroponotic protozoal infection acquired from sand fly bite, which causes substantial morbidity and mortality in endemic areas. We conducted the study to look at the clinical characteristics and outcome of VL patients in Gondar University Hospital.

Objective: The study aims to evaluate clinical characteristics of VL as related to presenting features, poor prognostic indicators and treatment outcome.

Methods: This is a retrospective review of medical records of patients admitted with the diagnosis of VL to the Medical Ward of

Gondar University Hospital (GUH) from Sep.10, 2005 to June 30, 2007.

Results: During the 2- year review period, 81 patients were admitted with a diagnosis of VL. The diagnosis was made on patients who presented with fever > 2 weeks with splenomegaly and/or wasting, and confirmed by demonstration of parasite in tissue aspirate of bone marrow or spleen. The mean age of patients was 24 ± 7.18 yrs. The average duration of symptoms was 2.8 ± 2.1 months. The majority of the patients (67/81) presented with a complaint of fever. The most frequent clinical features were fever, cough, weight loss, pallor, hepatosplenomegaly and pancytopenia. Of all patients, five VL patients (16.1%) were co-infected with HIV and were clinically indistinguishable from HIV-negative patients. Pneumonia, otitis media and sepsis of gastro intestinal and pulmonary foci were the commonly encountered secondary bacterial infections. Among a total of 81 patients, 15 (18.5%) died and the rest discharged improved. The major cause of death was sepsis with septic shock, and drugrelated hepatic, renal and pancreatic toxicities.

Conclusions: The clinical and laboratory features including fever, cough, weight loss, hepatosplenomegaly and pancytopenia were the typical features of VL in our study. Secondary bacterial infections were commonly encountered in our hospitalized patients.

The major cause of death in this study was inter-current bacterial infection and drug-related organ dysfunction.