Factors associated with deaths due to visceral leishmaniasis among children at a hospital in the southwest of Maranhão state: a cross-sectional study, Imperatriz, 2010-2021.

Abstract

Objectives: To describe the clinical and epidemiological characteristics and analyze factors associated with deaths due to visceral leishmaniasis among children at a hospital in the southwest of Maranhão state.

Methods: This was a cross-sectional study conducted in Imperatriz, Maranhão, based on case reporting forms held on the Notifiable Health Conditions Information System provided by the Regional Epidemiological Surveillance and Disease Control Center. The study included all records of visceral leishmaniasis cases in children admitted to a pediatric referral hospital in Imperatriz between 2010 and 2021. Data were analyzed using descriptive statistics, determining absolute and relative values of the variables investigated. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated using univariate and multivariate regression.

Results: A total of 404 cases of the disease were recorded, of which 43 resulted in death. Of these, the majority were new cases (95.4%), females (53.5%), of mixed race/skin color (65.1%), and resident in the urban zone (60.5%) who presented clinical manifestations such as enlarged spleen (88.4%), skin pallor (86.0%), weight loss (69.8%), edema (60.5%), fever (95.4%), and enlarged liver (51.2%). In the final regression model, living in the rural zone was considered a risk factor (OR 2.96; 95%CI 1.35; 6.50), while being between 1 and 4 years old was a protective factor (OR 0.23; 95%CI 0.11; 0.50) against death from the disease.

Conclusion: The findings highlighted the need for targeted strategies to improve early diagnosis and management of visceral leishmaniasis, especially in rural areas.