Wudu Habitamu, Alemu Chekol
Department of Statistics, College of Natural and Computational Sciences, Gambella University, Gambella, Ethiopia.
Sci Rep. 2024 Dec 30;14(1):32045. doi: 10.1038/s41598-024-83716-6.
Visceral leishmaniasis (VL) is a neglected tropical disease that mostly affects the working-class and impoverished segments of society, having a significant negative effect on the economic development of the affected nation. While anti-leishmanial medications lower mortality among VL patients, patients may still die or require more time to recover (TTR) while receiving treatment. In this regard, there are limited studies in Ethiopia. This study aims to determine the time to recovery and its associated predictors among adult VL patients at Metema Hospital. A hospital-based cross-sectional study design was employed, and the data were collected in patient's charts from September 2017 to September 2021. Data were entered and analyzed using Epi-data, STATA version 14.2, and R 3.4.0 statistical software. The Kaplan-Meier survival curve and log-rank tests were used to compare the survival time. The Cox proportional hazard model assumption and model fitness were checked and used to identify statistical association predictors in VL patients. The Cox proportional hazard (Cox-PH) model was fitted. The overall medium recovery time was 7 days (minimum 4, maximum 14 days). The variables nasal bleeding (adjusted hazard ratio/AHR: 0.44; 95% CI: 0.19-0.89), no comorbidity (AHR: 2.29; 95% CI: 1.27-4.11), relapse VL (AHR: 0.33; 95% CI: 0.15-0.75),low parasite load (AHR: 2.58; 95% CI: 1.48-4.51), and ambulatory (AHR: 3.26; 95% CI: 2.45-6.53) were significantly associated with TTR in VL patients. Patients with comorbidities, nasal bleeding, relapse VL, bedridden, and high parasite load should be treated and monitored carefully to recover quickly from their illness.
内脏利什曼病(VL)是一种被忽视的热带疾病,主要影响社会中的工人阶级和贫困阶层,对受影响国家的经济发展产生重大负面影响。虽然抗利什曼药物可降低VL患者的死亡率,但患者在接受治疗期间仍可能死亡或需要更长的恢复时间(TTR)。在这方面,埃塞俄比亚的相关研究有限。本研究旨在确定梅特马医院成年VL患者的恢复时间及其相关预测因素。采用基于医院的横断面研究设计,数据收集于2017年9月至2021年9月的患者病历中。使用Epi-data、STATA 14.2版和R 3.4.0统计软件录入和分析数据。采用Kaplan-Meier生存曲线和对数秩检验比较生存时间。检查Cox比例风险模型假设和模型拟合情况,并用于识别VL患者的统计学关联预测因素。拟合了Cox比例风险(Cox-PH)模型。总体平均恢复时间为7天(最短4天,最长14天)。鼻出血(调整后风险比/AHR:0.44;95%置信区间:0.19-0.89)、无合并症(AHR:2.29;95%置信区间:1.27-4.11)、复发性VL(AHR:0.33;95%置信区间:0.15-0.75)、低寄生虫载量(AHR:2.58;95%置信区间:1.48-4.51)和能走动(AHR:3.26;95%置信区间:2.45-6.53)等变量与VL患者的TTR显著相关。患有合并症、鼻出血、复发性VL、卧床不起和寄生虫载量高的患者应接受仔细治疗和监测,以便尽快康复。