[Visceral leishmaniasis: clinical and epidemiological features of children in an endemic area].

OBJECTIVE

To describe the clinical and epidemiological features of children with visceral leishmaniasis admitted to a pediatric referral hospital, and to describe treatment measures and the case fatality rate.

METHODS

Retrospective analysis of biological, demographic, clinical and laboratory data from children with visceral leishmaniasis admitted to Instituto Materno Infantil de Pernambuco (Recife, state of Pernambuco, northeastern Brazil) between 1996 and 2001.

RESULTS

431 children were included in the study. Age ranged from 4 months to 13.7 years. 50.3% were female and 82.5% came from the interior of the state of Pernambuco. 70% of the patients lived in brick homes, and 70% were not served with piped water and sewage services. Average maternal schooling was 3 years. Clinical presentation included splenomegaly (97%), fever (95.6%) and malnourishment (44.5%). Associated infections were diagnosed in 10.9% of cases. The mean values for laboratory variables were: hemoglobin 6 g/dl, leukocyte count 3,516/mm(3), and platelet count 118,641/mm(3). The first line treatment used in 98% of the cases was glucantime. Amphotericin B was used in seven cases. The case fatality rate was 10.2%. The main immediate causes of death were associated infections, bleeding and liver failure.

CONCLUSIONS

Health care workers should be trained for the early recognition and appropriate management of visceral leishmaniasis and its complications.