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Risk factors for mortality of children with zoonotic visceral leishmaniasis in Central Tunisia.

Abstract Zoonotic visceral leishmaniasis (ZVL) caused by Leishmania infantum is endemic with an epidemiological profile of a paediatric disease in Tunisia. In the context of a high fatality rate, identifying risk factors for in-hospital mortality in children treated for ZVL is of major epidemiological importance.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plos one
Publication Year Start




PMID- 29287082
OWN - NLM
STAT- In-Data-Review
LR  - 20171229
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Risk factors for mortality of children with zoonotic visceral leishmaniasis in
      Central Tunisia.
PG  - e0189725
LID - 10.1371/journal.pone.0189725 [doi]
AB  - BACKGROUND: Zoonotic visceral leishmaniasis (ZVL) caused by Leishmania infantum
      is endemic with an epidemiological profile of a paediatric disease in Tunisia. In
      the context of a high fatality rate, identifying risk factors for in-hospital
      mortality in children treated for ZVL is of major epidemiological importance.
      DESIGN: A retrospective (case-control) study included 230 immuno-competent
      children diagnosed and confirmed with primary ZVL in the paediatric department of
      the University Hospital of Kairouan between 2004 and 2014. Forty-seven per cent
      (47%) were children under 18 months of age, and with a male female ratio of
      1.01:1. RESULTS: The overall case-fatality was 6% (n = 14). The risk factors for 
      in-hospital death identified by a multivariate analysis were: bleeding at
      admission (OR = 25.5, 95% CI: 2.26-287.4; p = 0.009), white cell count less than 
      4000/mm3 (OR = 5.66, 95% CI: 1.16-27.6; p = 0.032), cytolysis (OR = 28.13, 95%
      CI: 4.55-173.6; p < 0.001), and delay between onset of symptoms and admission >/=
      15 days (OR = 11, 95% CI: 1.68-72; p = 0.012). CONCLUSION: The results strongly
      suggest that paediatric patients admitted 15 days after onset of symptoms, with
      bleeding, white cell counts below 4,000/mm3, and cytolysis at admission should be
      considered severe cases and subsequently, they are at high risk of mortality. A
      better understanding of factors associated with death of children from ZVL may
      contribute to decrease mortality.
FAU - Ben Helel, Khaled
AU  - Ben Helel K
AD  - Pediatric Department of University Hospital of Kairouan, Kairouan, Tunisia.
FAU - Ben Rejeb, Mohamed
AU  - Ben Rejeb M
AD  - Department of Prevention and Care Safety, University Hospital of Sahloul, Sousse,
      Tunisia.
FAU - Habboul, Zakia
AU  - Habboul Z
AD  - Pediatric Department of University Hospital of Kairouan, Kairouan, Tunisia.
FAU - Khattat, Nizar
AU  - Khattat N
AD  - Pediatric Department of University Hospital of Kairouan, Kairouan, Tunisia.
FAU - Mejaouel, Houssain
AU  - Mejaouel H
AD  - Pediatric Department of University Hospital of Kairouan, Kairouan, Tunisia.
FAU - Said-Latiri, Houyem
AU  - Said-Latiri H
AD  - Department of Prevention and Care Safety, University Hospital of Sahloul, Sousse,
      Tunisia.
FAU - Kaabi, Belhassen
AU  - Kaabi B
AD  - Pasteur Institute of Tunis, Tunis, Tunisia.
FAU - Zhioua, Elyes
AU  - Zhioua E
AD  - Pasteur Institute of Tunis, Tunis, Tunisia.
LA  - eng
PT  - Journal Article
DEP - 20171229
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
EDAT- 2017/12/30 06:00
MHDA- 2017/12/30 06:00
CRDT- 2017/12/30 06:00
PHST- 2017/06/04 00:00 [received]
PHST- 2017/11/30 00:00 [accepted]
PHST- 2017/12/30 06:00 [entrez]
PHST- 2017/12/30 06:00 [pubmed]
PHST- 2017/12/30 06:00 [medline]
AID - 10.1371/journal.pone.0189725 [doi]
AID - PONE-D-17-21351 [pii]
PST - epublish
SO  - PLoS One. 2017 Dec 29;12(12):e0189725. doi: 10.1371/journal.pone.0189725.
      eCollection 2017.