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Prevalence, features and risk factors for Malaria co-infections amongst visceral leishmaniasis patients from Amudat Hospital, Uganda
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van den Bogaart, Erika, Berkhout, Marieke M. Z., Adams, Emily R., Mens, Pètra F., Sentongo, Elizabeth, Mbulamberi, Dawson B., Straetemans, Masja, Schallig, Henk D. F. H. and Chappuis, Francois (2012) Prevalence, features and risk factors for Malaria co-infections amongst visceral leishmaniasis patients from Amudat Hospital, Uganda. PLoS Neglected Tropical Diseases, 6 (4). e1617. doi:10.1371/journal.pntd.0001617 ISSN 1935-2735.
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Official URL: http://dx.doi.org/10.1371/journal.pntd.0001617
Abstract
Background and methodology
Due to geographic overlap of malaria and visceral leishmaniasis (VL), co-infections may exist but have been poorly investigated. To describe prevalence, features and risk factors for VL-malaria co-infections, a case-control analysis was conducted on data collected at Amudat Hospital, Uganda (2000–2006) by Médecins sans Frontières. Cases were identified as patients with laboratory-confirmed VL and malaria at hospital admission or during hospitalization; controls were VL patients with negative malaria smears. A logistic regression analysis was performed to study the association between patients' characteristics and the occurrence of the co-infection.
Results
Of 2414 patients with confirmed VL, 450 (19%) were positively diagnosed with concomitant malaria. Most co-infected patients were males, residing in Kenya (69%). While young age was identified by multivariate analysis as a risk factor for concurrent VL and malaria, particularly the age groups 0–4 (odds ratio (OR): 2.44; 95% confidence interval (CI): 1.52–3.92) and 5–9 years (OR: 2.23, 95% CI: 1.45-3-45), mild (OR: 0.53; 95% CI: 0.32–0.88) and moderate (OR: 0.45; 95% CI: 0.27–0.77) anemia negatively correlated with the co-morbidity. VL patients harboring skin infections were nearly three times less likely to have the co-infection (OR: 0.35; 95% CI: 0.17–0.72), as highlighted by the multivariate model. Anorexia was slightly more frequent among co-infected patients (OR: 1.71; 95% CI: 0.96–3.03). The in-hospital case-fatality rate did not significantly differ between cases and controls, being 2.7% and 3.1% respectively (OR: 0.87; 95% CI: 0.46–1.63).
Conclusions
Concurrent malaria represents a common condition among young VL patients living in the Pokot region of Kenya and Uganda. Although these co-morbidities did not result in a poorer prognosis, possibly due to early detection of malaria, a positive trend towards more severe symptoms was identified, indicating that routine screening of VL patients living in malaria endemic-areas and close monitoring of co-infected patients should be implemented.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Malaria -- Infections -- Uganda, Kala-azar -- Infections -- Uganda, Médecins sans frontières (Association) | ||||
Journal or Publication Title: | PLoS Neglected Tropical Diseases | ||||
Publisher: | Public Library of Science | ||||
ISSN: | 1935-2735 | ||||
Official Date: | April 2012 | ||||
Dates: |
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Volume: | 6 | ||||
Number: | 4 | ||||
Article Number: | e1617 | ||||
DOI: | 10.1371/journal.pntd.0001617 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Funder: | Koninklijk Instituut voor de Tropen [Royal Tropical Institute of Amsterdam] | ||||
Adapted As: |
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