دورية أكاديمية
أعرض في EDS

A clinical severity scoring system for visceral leishmaniasis in immunocompetent patients in South Sudan.

التفاصيل البيبلوغرافية
العنوان: A clinical severity scoring system for visceral leishmaniasis in immunocompetent patients in South Sudan.
المؤلفون: Kämink SS; Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.; Department Health Sciences, Vrije Universiteit, Amsterdam, The Netherlands., Collin SM; Population Health Sciences, Bristol Medical School University of Bristol, Bristol, United Kingdom., Harrison T; Médecins Sans Frontières, Lankien, South Sudan., Gatluak F; Médecins Sans Frontières, Lankien, South Sudan., Mullahzada AW; Médecins Sans Frontières, Lankien, South Sudan., Ritmeijer K; Public Health Department, Médecins Sans Frontières, Amsterdam, The Netherlands.
المصدر: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2017 Oct 02; Vol. 11 (10), pp. e0005921. Date of Electronic Publication: 2017 Oct 02 (Print Publication: 2017).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Endemic Diseases* , Severity of Illness Index*, Leishmaniasis, Visceral/*epidemiology, Adolescent ; Adult ; Child ; Decision Support Techniques ; Female ; Hospitalization ; Humans ; Immunocompetence ; Leishmaniasis, Visceral/drug therapy ; Leishmaniasis, Visceral/mortality ; Leishmaniasis, Visceral/physiopathology ; Logistic Models ; Male ; Middle Aged ; Odds Ratio ; ROC Curve ; Recurrence ; Retrospective Studies ; Risk Factors ; South Sudan/epidemiology ; Young Adult
مستخلص: Background: South Sudan is one of the most endemic countries for visceral leishmaniasis (VL), and is frequently affected by large epidemics. In resource-limited settings, clinicians require a simple clinical tool to identify VL patients who are at increased risk of dying, and who need specialised treatment with liposomal amphotericin B and other supportive care. The aim of this study was to develop and validate a clinical severity scoring system based on risk factors for death in VL patients in South Sudan.
Methods: A retrospective analysis was conducted of data from a cohort of 6,633 VL patients who were treated in the Médecins Sans Frontières (MSF) hospital in Lankien between July 2013 and June 2015. Risk factors for death during treatment were identified using multivariable logistic regression models, and the regression coefficients were used to develop a severity scoring system. Sensitivity and specificity of score cut-offs were assessed by receiver operating characteristic (ROC) analysis.
Results: In multivariable models, risk factors for death in adult VL patients were: anaemia (odds ratio (OR) 4.46 (95% CI 1.58-12.6) for Hb <6g/dL compared with ≥9g/dL), nutritional status (OR 4.84 (2.09-11.2) for BMI <13 kg/m2 compared with ≥16 kg/m2), weakness (OR 4.20 (1.82-9.73) for collapsed compared with normal weakness), jaundice (OR 3.41 (1.17-9.95)), and oedema/ascites (OR 4.86 (1.67-14.1)). For children and adolescents the risk factors were: age (OR 10.7 (6.3-18.3) for age <2 years compared with 6-18 years), anaemia (OR 7.76 (4.15-14.5) for Hb <6g/dL compared with ≥9g/dL), weakness (OR 3.13 (22.8-105.2) for collapsed compared with normal weakness), and jaundice (OR 12.8 (4.06-40.2)). Severity scoring predictive ability was 74.4% in adults and 83.4% in children and adolescents.
Conclusion: Our evidenced-based severity scoring system demonstrated sufficient predictive ability to be operationalised as a clinical tool for rational allocation of treatment to VL patients at MSF centres in South Sudan.
References: Circulation. 2007 Feb 20;115(7):928-35. (PMID: 17309939)
Trop Med Int Health. 2006 Apr;11(4):509-12. (PMID: 16553934)
PLoS Negl Trop Dis. 2010 Jun 08;4(6):e705. (PMID: 20544032)
Int J Epidemiol. 2008 Apr;37(2):344-52. (PMID: 18184669)
JAMA. 1997 Aug 13;278(6):491-6. (PMID: 9256224)
J Glob Infect Dis. 2010 May;2(2):151-8. (PMID: 20606971)
Stat Med. 1996 Feb 28;15(4):361-87. (PMID: 8668867)
Trans R Soc Trop Med Hyg. 2003 Nov-Dec;97(6):609-13. (PMID: 16134257)
Clin Infect Dis. 2004 Mar 1;38(5):612-9. (PMID: 14986243)
Ann Intern Med. 1996 Apr 1;124(7):664-72. (PMID: 8607595)
Epidemiology. 2010 Jan;21(1):128-38. (PMID: 20010215)
PLoS Negl Trop Dis. 2012;6(6):e1674. (PMID: 22724029)
Expert Opin Emerg Drugs. 2012 Dec;17(4):493-510. (PMID: 23167833)
Trans R Soc Trop Med Hyg. 2001 Nov-Dec;95(6):668-72. (PMID: 11816442)
PLoS Negl Trop Dis. 2014 Mar 27;8(3):e2720. (PMID: 24675573)
Trop Med Int Health. 2015 Dec;20(12):1674-84. (PMID: 26427033)
Clin Infect Dis. 1995 Jul;21(1):188-93. (PMID: 7578729)
PLoS One. 2012;7(5):e35671. (PMID: 22693548)
Am J Trop Med Hyg. 2009 Jun;80(6):929-34. (PMID: 19478251)
Am J Trop Med Hyg. 2007 Jul;77(1):89-94. (PMID: 17620635)
Antimicrob Agents Chemother. 2011 Jan;55(1):455-6. (PMID: 21078947)
BMJ. 1990 Jan 27;300(6719):223-6. (PMID: 2106929)
BMJ. 2009 May 28;338:b605. (PMID: 19477892)
Clin Microbiol Infect. 2011 Oct;17(10):1478-83. (PMID: 21933306)
Malar J. 2015 May 28;14 :219. (PMID: 26017395)
Ann Intern Med. 2003 Apr 15;138(8):644-50. (PMID: 12693887)
BMJ. 2003 Feb 15;326(7385):361. (PMID: 12586667)
BMJ. 2009 Mar 31;338:b604. (PMID: 19336487)
PLoS Negl Trop Dis. 2014 Dec 11;8(12):e3374. (PMID: 25503575)
تواريخ الأحداث: Date Created: 20171003 Date Completed: 20171027 Latest Revision: 20181113
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC5638606
DOI: 10.1371/journal.pntd.0005921
PMID: 28968400
قاعدة البيانات: MEDLINE
الوصف
تدمد:1935-2735
DOI:10.1371/journal.pntd.0005921