ArticlePLoS neglected tropical diseases2016
Epidemiologic Correlates of Mortality among Symptomatic Visceral Leishmaniasis Cases: Findings from Situation Assessment in High Endemic Foci in India.
Article in PLoS neglected tropical diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Spatial variation in time to diagnosis of visceral leishmaniasis in Bihar, India.BMC global and public health · 2025Article
- Targeted Oral Fixed-Dose Combination of Amphotericin B-Miltefosine for Visceral Leishmaniasis.Molecular pharmaceutics · 2025Article
- Time to recovery from visceral leishmaniasis and its predictors of mature visceral leishmaniasis patients admitted at Metema Hospital, Metema, Ethiopia.Scientific reports · 2024Article
- Treatment Outcomes of Single-Dose Liposomal Amphotericin B-Treated Visceral Leishmaniasis Patients and Factors Affecting Outcome in Bihar, India.The American journal of tropical medicine and hygiene · 2024Article
- Case Report: The First Case Report of Visceral Leishmaniasis in Cambodia.The American journal of tropical medicine and hygiene · 2022Article
- Impact of intensified control on visceral leishmaniasis in a highly-endemic district of Bihar, India: an interrupted time series analysis.Epidemics · 2022Article
- Article
- Vaccines against leishmaniasis: using controlled human infection models to accelerate development.Expert review of vaccines · 2021Article
- Improved kala-azar case management through implementation of health facility-based sentinel sites surveillance system in Bihar, India.PLoS neglected tropical diseases · 2021Article
- Inequalities of visceral leishmaniasis case-fatality in Brazil: A multilevel modeling considering space, time, individual and contextual factors.PLoS neglected tropical diseases · 2021Article
- Mathematical modelling of the use of insecticide-treated nets for elimination of visceral leishmaniasis in Bihar, India.Royal Society open science · 2021Article
- Visceral leishmaniasis outbreaks in Bihar: community-level investigations in the context of elimination of kala-azar as a public health problem.Parasites & vectors · 2021Article
- Optimizing Village-Level Targeting of Active Case Detection to Support Visceral Leishmaniasis Elimination in India.Frontiers in cellular and infection microbiology · 2021Article
- Incidence of Mortality and Its Predictors Among Adult Visceral Leishmaniasis Patients at the University of Gondar Hospital: A Retrospective Cohort Study.Infection and drug resistance · 2020Article
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- Article
- Sex-Related Differences in Immune Response and Symptomatic Manifestations to Infection withJournal of immunology research · 2019Review
- The role of case proximity in transmission of visceral leishmaniasis in a highly endemic village in Bangladesh.PLoS neglected tropical diseases · 2018Article
- Understanding Leishmania parasites through proteomics and implications for the clinic.Expert review of proteomics · 2018Review
- Epidemiological and Experimental Evidence for Sex-Dependent Differences in the Outcome ofThe American journal of tropical medicine and hygiene · 2018Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVisceral leishmaniasis (VL) is highly prevalent in the Indian state of Bihar and, without proper diagnosis and treatment, is associated with high fatality. However, lack of efficient reporting mechanism had been an impediment in estimating the burden of mortality and its antecedents among symptomatic VL cases. The objectives of the current study were to generate a reliable estimate of symptomatic VL caseload and mortality in Bihar, as well as to identify the epidemiologic and health infrastructure-related predictors of VL mortality. METHODOLOGY AND PRINCIPAL
findingsUsing an elaborate index case tracing method, we attempted to locate all symptomatic VL patients in eight districts of Bihar. Interviews and medical-record-reviews were conducted with cases (or next-of-kin for the dead) meeting the eligibility criteria. The information collected during the interviews included socio-demographic characteristics, onset of disease symptoms, place of diagnosis, pre- and post-diagnosis treatment history, type and duration of drugs received. In total, we analyzed data on 4925 VL patients-59% were male and 68% were less than 30 years old. There were 158 (3.2%) deaths and the incidence rate of mortality was 3.2/100 person-years. In the adjusted Cox-proportional-hazards analysis, treatment at public facility [Adjusted Hazard Ratio (AHR) = 0.61; 95% CI = 0.43-0.86], shorter (≤30 days) diagnostic delay [AHR = 0.62, 95% CI = 0.43-0.92], and treatment completion [AHR = 0.03, 95% CI = 0.02-0.05] emerged as significant negative predictors of mortality.
conclusionMortality reduction efforts in Bihar should focus on improving access to early diagnosis, quality treatment and treatment-adherence measures, with special emphasis on marginalized communities.
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